CAJ | 학술논문

　　目的：探讨术中血液回输技术对脊柱外科围术期病人出凝血和血携氧功能的影响。方法：筛选2010年1月至2013年1月期间在我院骨科住院就诊的100例本市脊柱损伤患者，根据手术的方法平均分为5组，分别是脊柱骨折前路手术组、脊柱骨折后路手术组、腰椎滑脱内固定手术组、脊柱侧弯矫治术组、多节段椎间盘突出症并椎管狭窄组、检测各组患者术前、术后24小时、术后7天血液中血红蛋白（Hb）、氧分压（PaO2）、血小板（PLT）等指标，同时比较5组患者回收式自体输血（ATS）量的变化及其对出凝血状况和血携氧功能的影响。结果：100例共输血75350ml ，自体血回输59390ml ，所占比例78．82％，在手术后各时间段内红细胞比容（HCT）、PLT 水平均出现下降，空腹血糖（Fbg）无明显差别，而PaO2水平上升明显。结论：围手术期虽有轻度贫血但不影响血携氧功能，术后 PT 显著延长却未出现出凝血功能障碍，ATS 技术能明显减少异体血用量，可安全应用于脊柱外科手术。
　　목적：탐토술중혈액회수기술대척주외과위술기병인출응혈화혈휴양공능적영향。방법：사선2010년1월지2013년1월기간재아원골과주원취진적100례본시척주손상환자，근거수술적방법평균분위5조，분별시척주골절전로수술조、척주골절후로수술조、요추활탈내고정수술조、척주측만교치술조、다절단추간반돌출증병추관협착조、검측각조환자술전、술후24소시、술후7천혈액중혈홍단백（Hb）、양분압（PaO2）、혈소판（PLT）등지표，동시비교5조환자회수식자체수혈（ATS）량적변화급기대출응혈상황화혈휴양공능적영향。결과：100례공수혈75350ml ，자체혈회수59390ml ，소점비례78．82％，재수술후각시간단내홍세포비용（HCT）、PLT 수평균출현하강，공복혈당（Fbg）무명현차별，이PaO2수평상승명현。결론：위수술기수유경도빈혈단불영향혈휴양공능，술후 PT 현저연장각미출현출응혈공능장애，ATS 기술능명현감소이체혈용량，가안전응용우척주외과수술。
Objective :To investigate intraoperative autotransfusion of blood coagulation and blood oxygen carrying function of spine surgery pa-tients in perioperative period .Methods :From January 2013 screening during the 2010 January hospitalized in Department of orthopedics in our hospi-tal 100 cases the spine injury patients ,according to the methods of operation were divided into 5 groups ,respectively is the fracture of spine anterior operation group ,operation group ,spinal fractures of posterior lumbar spondylolisthesis internal fixation operation group ,the spinal scoliosis correc-tion surgery group ,multiple intervertebral disc herniation and spinal canal stenosis group ,patients in each group were determined before surgery ,24 hours ,7 days after operation ,blood hemoglobin (Hb) ,partial pressure of oxygen (PaO2) ,platelet (PLT) and other indicators ,at the same time , compared 5 groups of patients with autologous blood transfusion (ATS) affect the amount of change and the coagulation status and blood oxygen car-rying function .Result:100 cases of transfusion of autologous blood transfusion in 75350ml ,59390ml ,the proportion of 78 .82% in different time af-ter the operation ,red cell volume (HCT) ,PLT levels were decreased ,fasting blood glucose (Fbg) had no significant difference ,while the PaO2 lev-el increased significantly .Conclusion:Peri operation period has a mild anemia but does not affect the ability of blood to carry oxygen ,postoperative PT was significantly prolonged without coagulation dysfunction ,ATS technology can significantly reduce the amount of homologous blood ,it can be safely used in spine surgery operation .