血液回收技术对婴幼儿心脏外科术后临床结果的影响

摘要

目的：评价心脏矫治术期间使用血液回收（ CS）技术处理回输术中出血及体外循环（ CPB）管路余血对心脏外科患儿节约用血的意义和对临床结果的影响。方法根据术中是否使用CS，将100例在CPB下行先天性心脏病矫治术的患儿随机分为两组：洗血球组（ CS组，n＝50）和对照组（ CON组，n＝50）。记录两组患儿围术期红细胞比容（ Hct），术后输入洗涤红细胞（ RBCs）、血浆及血小板量，术后肝肾功能，术后24 h胸腔引流量，升压药使用时间和机械通气时间、ICU时间和住院时间，并进行统计学分析。结果两组患儿均痊愈出院。术后输入库血量及术后输血率CS组均明显低于CON组（ P＜0．05）。术后升压药使用时间CS组明显低于CON组（ P＜0．05）。两组患儿其余指标及术后恢复情况无明显差异（ P＞0．05）。结论对先天性心脏病婴幼儿手术期间使用CS处理术中出血和CPB管路余血可以明显减少术后输血量以及输血患儿的比率，达到节约用血的目的。%Objective To evaluate whether cell saver used in pediatric patients undergoing cardiac surgery would decrease the number of post-operative allogeneic RBCs transfusions and possibly improve the clinical outcomes. Methods A total of 100 pediatric patients with congenital heart disease received elective cardiac surgery in our hospital from Aug. 2014 to Dec. 2014 were studied. Sub⁃jects were randomized to a cell saver transfusion group where cell saver blood was available for transfusion up to the end of the opera⁃tion, or to a control group, n =50 in each group. Blood product transfusions, and clinical outcomes were compared between groups. Results Children randomized to the cell saver group had significantly fewer RBC transfusions ( P<0.05) , and significantly fewer do⁃nor exposures ( P<0.05) . There were no significant clinical outcome differences. Conclusion Cell saver can reduce post-operative allogeneic RBC transfusion in pediatric patients undergoing cardiac surgery.