摘要
[目的]评估人工关节置换术后伤口引流血自体回输的有效性及安全性。[方法]选取2009年2～5月间于本科行人工髋、膝关节置换术的30例患者作为研究对象,应用ContavacTMCBCⅡ自体血液回输器回输术后6h内伤口引流血,根据患者异体输血量、血红蛋白水平变化以及伤口引流血中红细胞形态评价引流血自体回输的有效性;根据患者有无发热、溶血反应、凝血功能障碍、肺栓塞、脂肪栓塞、全身感染等以评估引流血自体回输的安全性。[结果]平均每例患者伤口总出血量为(946±433)ml,自体血回输(622±313)ml,异体输血(233±348)ml;伤口引流血中红细胞形态完整,血红蛋白含量为99.67g/L,术后第1d较术后即刻血红蛋白显著降低。1例患者出现异常发热,无患者发生其他并发症。[结论]人工关节置换术后6h内的伤口引流血为有效血液成分,回输后能够减缓血色素下降速度,节省术后异体血用量,是一种安全、有效补充血液成分的方法。
[Objective] To evaluate the efficacy and safety of drainage blood autotransfusion after total knee or hip arthroplasty.[Methods]Drainage blood in the first 6 hours postoperation was collected and reinfused using the ContavacTM CBCⅡ system in 30 patients taken total knee or hip arthroplasty.The efficacy was evaluated basing on the amount of the allogenic transfusion,the decreasing of the hemoglobin level and the morphology of the red blood cells in the drainage blood.The safety was evaluated basing on whether the patients had autotransfusion complications including fever,hemolytic reaction,coagulation disorders,pulmonary embolism and systemic infection.[Results]The volumes of total blood drainage,autotransfusion and allogenic transfusion were（946±433）ml,（622±313）ml and（233±348）ml,respectively.The average hemoglobin level of drainage blood was 99.67g/L and no apparente haemolysis happened.However,the hemoglobin level significantly decreased after operation in the peripheral blood.Only one rheumatoid arthritis patient had an abnormal fever during autotransfusion process,no other complication was observed.[Conclusion]Drainage blood in the first 6 hours postoperation is valid blood content.Drainage blood autotransfusion is an effective and safe way to slow down the hemoglobin reduction and reduce allogenic blood transfusion in patients being treated with total knee or hip arthroplasty.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2010年第5期381-384,共4页
Orthopedic Journal of China
