预存式自体输血与术中回收式自体输血对择期手术患者机体免疫功能的影响研究

摘要

目的 探讨预存式自体输血与术中回收式自体输血对择期手术患者机体免疫功能的影响.方法 回顾性分析该院2014年9月至2016年8月收治的100例择期手术患者临床资料,按输血方式将其分为研究组与对照组各50例,对照组患者术中输异体血,研究组患者采用预存式自体输血与术中回收式自体输血进行自体输血,比较两组患者一般指标、免疫细胞及免疫球蛋白水平.结果 研究组患者异体血输入量及术后切口感染率较对照组低,差异有统计学意义(P<0.05).术中、术后及总失血量组间比较差异无统计学意义(P>0.05).术前两组患者免疫细胞水平比较差异无统计学意义(P>0.05).术后1 d及7 d,研究组患者CD3+、CD4+、CD4+/CD8+及NK细胞水平均较对照组高,CD8+较对照组低,差异有统计学意义(P<0.05).术前两组患者免疫球蛋白水平比较差异无统计学意义(P>0.05).术后1 d及7 d,研究组患者Ig G、Ig M及C3水平均高于对照组,差异均有统计学意义(P<0.05).结论 术中回收式自体输血与预存式自体输血联用对择期手术患者免疫功能影响较异体输血小,安全性较好.%Objective To investigate the influence of predeposited autotransfusion and intraoperative autotransfusion on immune function of patients with selective operation .Methods A retrospective analysis was made on 100 cases of patients with selective op-eration in our hospital from September 2014 to August 2016 ,and all cases were divided into control group and research group .Con-trol group was treated with allogeneic transfusion ,while research group was treated with combination of preoperative autologous blood donation and intraoperative autotransfusion ,and general indexes ,immune cells and immune protein levels between two groups were compared .Results The allogeneic transfusion volume and postoperative incision infection rate of research group were lower than those of control group ,and the difference was statistically significant (P<0 .05) .There was no significant difference in intrao-perative ,postoperative and total blood loss between the two groups (P>0 .05) .Before treatment ,immune cell level between two groups had no significant difference (P>0 .05) .At 1 d and 7 d after surgery ,CD3+ ,CD4+ ,CD4+ /CD8+ and NK cell levels of re-search group were higher than those of control group ,CD8+ level of research group was lower than that of control group ,and the difference was statistically significant (P<0 .05) .Before treatment ,immunoglobulin level between two groups had no difference (P>0 .05) .At 1 d and 7 d after surgery ,IgG ,IgM and C3 levels of research group were higher than those of control group ,and the difference was statistically significant (P<0 .05) .Conclusion Combination of predeposited autotransfusion and intraoperative au-totransfusion has fewer influence on immune function of patients with selective operation ,and has good safety .