心脏直视手术不用异体库血的研究

目的　通过对心脏直视手术患者采用自体输血的临床应用 ,观察不用异体库血进行心脏直视手术的效果。方法　对应用自体输血进行心脏直视手术的 68例患者术中采用综合节血措施 ,包括术前贮血 ,术中回收血以及应用抑肽酶。同时选择 68例接受输异体库血的心脏直视手术患者作为对照 ,比较两组间中心静脉压 (CVP)、血红蛋白 (Hb)、血小板 (PLT)及术后引流量等差异。结果　自体输血组患者术后Hb、PLT均较术前降低 (P <0 .0 5 ) ,凝血酶原时间 (PT)延长(P <0 .0 5 ) ,但Hb、PLT、PT仍在正常范围内 ,PaO2 术后较术前显著升高 ;与对照组相比 ,术后Hb、PLT、PT及引流量均无统计学显著性差异 (P >0 .0 5 ) ,而术中失血量、用库血量却有明显差异。结论　采用自体输血的心脏直视手术患者 ,围术期虽有轻度贫血但不影响血液的携氧功能 ,术后出、凝血状况亦不受影响 ,并能减少输异体库血后可能引起的并发症、减轻患者的经济及精神负担。

Study on open heart surgery without homologous blood transfusion

Objective To study the effect of intraoperative autologous blood transfustion in cardiovascular surgery. Methods In 68 cases undergoing open heart surgery, comprehensive measures of blood conservation were taken, including autologous blood collected before operation retransfusion of blood and aprotinin during operation. Other 68 cases undergoing open heart surgery with homologous blood transfusion were chosen. As control group and several variances such as postoperative CVP, Hb, PLT, and the volume of postoperative drainage were compared between the two groups. Results Although Hb and PLT of autotransfusion group significantly decreased and PT markedly prolonged postoperatively, Hb, PLT and PT were still within the normal range, PaO 2 significantly increased. There were no significant differences between the two groups in postoperative Hb, PLT, and the volume of drainage while the volume of blood loss during operation and usage of bank blood were significantly different. Conclusion Autotransfusion in open heart surgery can cause mild anaemia but does not affect the ability of blood to carry oxygen; the condition of coagulation is not influenced either, thus reducing complications and economic and mental burden of patients receiving homologous transfustion.