自体血液回收机在心脏瓣膜置换术中的应用研究
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摘要
目的:观察自体血液回收机在心脏瓣膜置换术中的应用效果。方法:选取2014年10月至2016年8月广西医科大学第十附属医院收治的100例体外循环(CPB)下行心脏瓣膜置换术的患者,根据是否采用自体血液回收机回收术野的血液分为研究组(经自体血液回收机处理)和对照组(未经自体血液回收机处理),每组50例。比较两组术前及术后1h、术后24h的血红蛋白(Hb)、红细胞计数(RBC)、凝血活酶时间(PT)及活化部分凝血酶时间(APTT),并统计两组患者血液回收量和库存血输入量。结果:与对照组比较,研究组回收血液量增多,术中红细胞输入量、术中血浆输入量、术后24h引流量、术后24h红细胞输入量减少,差异均有统计学意义(均P<0.05)。研究组术后1h、术后24hRBC、Hb水平高于对照组(P<0.05),术后24h APTT较对照组明显缩短(P<0.05)。结论:自体血液回收机可减少心脏瓣膜置换术中血液丢失及异体血液输入量,降低异体输血风险。
Objective:To observe the effect of applying the autologous blood recovery machine on patients with heart valve replacement.Methods:One hundred cases of patients with heart valve replacement under extracorporeal circulation were randomly divided into 2 groups:the observation group(n=50)in which the patients with the operation by the autologous blood recovery machine,and the control group(n=50)in which the patients without operation by the autologous blood recovery machine.Respectively collecting the venous blood to test hemoglobin(Hb),red blood cell count(RBC),thromboplastin time(PT),activated partial thromboplastin time(APTT)of patients from two groups 1h before and after the surgery and 24 h after the surgery.The reduction of blood and the input of banked blood of patients from two groups were observed.Results:The amount of blood collection,banked blood typing,RBC,and Hb of observation group were more than control group(P<0.01).The control of postoperative APTT was longer than the observation group(P<0.01).All of the operations on patients were smooth,restore good,and no deaths.Conclusion:Autologous blood recovery machine could effectively protect the red blood cells,decrease the allosome blood input,and reduce the risk of allogeneic blood transfusions may bring.
Objective:To observe the effect of applying the autologous blood recovery machine on patients with heart valve replacement.Methods:One hundred cases of patients with heart valve replacement under extracorporeal circulation were randomly divided into 2 groups:the observation group(n=50)in which the patients with the operation by the autologous blood recovery machine,and the control group(n=50)in which the patients without operation by the autologous blood recovery machine.Respectively collecting the venous blood to test hemoglobin(Hb),red blood cell count(RBC),thromboplastin time(PT),activated partial thromboplastin time(APTT)of patients from two groups 1h before and after the surgery and 24 h after the surgery.The reduction of blood and the input of banked blood of patients from two groups were observed.Results:The amount of blood collection,banked blood typing,RBC,and Hb of observation group were more than control group(P<0.01).The control of postoperative APTT was longer than the observation group(P<0.01).All of the operations on patients were smooth,restore good,and no deaths.Conclusion:Autologous blood recovery machine could effectively protect the red blood cells,decrease the allosome blood input,and reduce the risk of allogeneic blood transfusions may bring.
引文
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[7]白韬,熊荣生,邓盛.自体血液回收机在风心瓣膜置换手术中的应用[J].按摩与康复医学,2011,2(7):197-198.
[8]GU Y J,VERMEIJDEN W J,DE VRIES A J,et al.Influence of mechanical cell salvage on red blood cell aggregation,deformability,and 2,3-diphosphoglycerate in patients undergoing cardiac surgery with cardiopulmonary bypass[J].The Annals of Thoracic Surgery,2008,86(5):1570-1575.
[9]冯润光,侯萍,刘莉,等.活化凝血时间监测对心脏瓣膜置换术患者低分子肝素剂量及伤口引流量的影响[J].中国药业,2015(18):17-19.
[10]张志宏,覃军,黄岚,等.房间隔缺损封堵术后不同抗凝方案安全性及疗效分析[J].中国介入心脏病学杂志,2010,18(5):247-251.
[11]WATERS J H.Red blood cell recovery and reinfusion[J].Anesthesiology Clinics of North America,2005,23(2):283-294.
[12]SPARGIAS K,BOUBOULIS N,HALAPAS A,et al.Transaortic aortic valve replacement using the Edwards Sapien-XT Valve and the Medtronic Core Valve:initial experience[J].Hellenic Journal of Cardiology,2014,55(4):288-293.
[13]严宇,杨庆军,陈灏,等.血液回收在成人心脏瓣膜置换术中的应用价值[J].重庆医学,2015(7):929-930,933.
[2]梁友君,林丽珠,范海鸥,等.自体血回输技术在心脏瓣膜置换术中的应用研究[J].中国体外循环杂志,2012,10(1):13-15.
[3]刘玉妍,刘琴湘.心脏瓣膜置换术中自体血回收对患者凝血功能的影响[J].广东医学,2008,29(6):961-962.
[4]DURAN S,APTE M,ALARCON G S,et al.Features associated with,and the impact of,hemolytic anemia in patients with systemic lupus erythematosus:LX,results from a multiethnic cohort[J].Arthritis and Rheumatism,2008,59(9):1332-1340.
[5]ZHOU J.A review of the application of autologous blood transfusion[J].Brazilian Journal of Medical and Biological Research,2016,49(9):e5493.
[6]ARAUJO R L,PANTANALI C A,HADDAD L,et al.Does autologous blood transfusion during liver transplantation for hepatocellular carcinoma increase risk of recurrence?[J].World Journal of Gastrointestinal Surgery,2016,8(2):161-168.
[7]白韬,熊荣生,邓盛.自体血液回收机在风心瓣膜置换手术中的应用[J].按摩与康复医学,2011,2(7):197-198.
[8]GU Y J,VERMEIJDEN W J,DE VRIES A J,et al.Influence of mechanical cell salvage on red blood cell aggregation,deformability,and 2,3-diphosphoglycerate in patients undergoing cardiac surgery with cardiopulmonary bypass[J].The Annals of Thoracic Surgery,2008,86(5):1570-1575.
[9]冯润光,侯萍,刘莉,等.活化凝血时间监测对心脏瓣膜置换术患者低分子肝素剂量及伤口引流量的影响[J].中国药业,2015(18):17-19.
[10]张志宏,覃军,黄岚,等.房间隔缺损封堵术后不同抗凝方案安全性及疗效分析[J].中国介入心脏病学杂志,2010,18(5):247-251.
[11]WATERS J H.Red blood cell recovery and reinfusion[J].Anesthesiology Clinics of North America,2005,23(2):283-294.
[12]SPARGIAS K,BOUBOULIS N,HALAPAS A,et al.Transaortic aortic valve replacement using the Edwards Sapien-XT Valve and the Medtronic Core Valve:initial experience[J].Hellenic Journal of Cardiology,2014,55(4):288-293.
[13]严宇,杨庆军,陈灏,等.血液回收在成人心脏瓣膜置换术中的应用价值[J].重庆医学,2015(7):929-930,933.