自体输血在心脏择期手术中的应用

摘要

目的 观察自体输血在心脏择期手术中应用的临床效果.方法 选择行择期成人心脏手术患者40例,分为两组,A组为麻醉后储存自体血组,B组为对照组.A组在麻醉后用自体采血机从患者颈内静脉采血600 mL,血压有波动者适当应用血管活性药物或适当的补充胶体,B组不进行采血储存.监测两组患者术前、放血后、术后24 h血红蛋白(Hb)含量、红细胞压积(Hct)、凝血酶原时间(PT),术中失血量、总输血量及例数、血浆用量,术后24 h的引流量.结果 A组患者术中出血量少于B组 (P<0.05).术后24 h的引流量B组明显多于A组,术后24 h 两组患者Hb、Hct、PT差异无统计学意义(P＞0.05).围术期红细胞、血浆用量、需输血患者A组少于B组(P<0.05).结论 自体输血能减少心脏手术的临床用血,能减少术后的失血量,在整个围术期均比较安全.%Objective To evaluate the efficacy of auto - transfusion in elective heart surgery. Methods Forty a-dult patients with elective heart surgery were divided into two groups, Group A with postanesthetic autologous blood storage and Group B as control group. In Group A, 600 mL autologous blood were collected from the jugular vein by autologous blood machine postanestheticly, and vasoactive drugs or supplemented colliod fluid were applied when necessary. Hemoglobin ( Hb ), hematocrit ( Hct ) and prothrombin time ( PT ) were recorded preoperatively, after bloodletting, and 24 hours postoperatively. Intraoperative blood loss, cases required blood transfusion, total blood infusion, plasma infusion and 24 hour drainage postoperatively were also assessed. Results There was significant reduction in intraoperative blood loss in Group A compared with Group B ( P <0. 05 ). Less postoperative 24 hour drainage were observed in Group A than that in Group B. There were no significant differences between the two groups in Hb, Hct or PT at 24 hours postoperatively ( P >0. 05 ). However, significantly less perioperative red blood cells and plasma transfusion were spotted in Group A, so was the cases required blood transfusion ( P <0. 05 ). Conclusion Auto - transfusion reduces both blood usage and postoperative blood loss in heart surgery, providing safer perioperative care.