CAJ | 학술논문

目的：探讨预存自体血回输应用于腰椎滑脱手术的临床疗效、不良反应及应用价值。方法：选择80例因单节段腰椎滑脱接受腰椎后路减压、椎体复位、椎间植骨融合、椎弓根螺钉内固定手术并输血治疗的患者，其中预存自体血回输的患者40例作为A组，因拒绝术前预存自体血而输注异体血的40例患者作为B组，记录并比较两组患者的手术时间、术中失血量、术后引流量和输血量、血常规观察指标（红细胞、血红蛋白、红细胞比容）及输血相关不良反应。结果：两组的手术时间、术中失血量、术后引流量和输血量比较差异均无统计学意义（P>0.05）；两组不良反应比较差异有统计学意义（P<0.05）；两组输血后第1天血常规各观察指标降低，与输血前比较差异有统计学意义（P<0.05），两组间比较差异无统计学意义（P>0.05）；两组输血后第7天血常规各观察指标比较差异均有统计学意义（P<0.05）。结论：对腰椎滑脱手术患者来说，采用术前预存自体血回输及异体输血均能有效纠正术中术后失血性贫血，但术前预存自体血回输能降低输血不良反应发生率，输血后患者血常规各观察指标恢复更快，在当前异体血供血困难的前提下，术前预存自体血回输是一种值得临床推广的方法。
목적：탐토예존자체혈회수응용우요추활탈수술적림상료효、불량반응급응용개치。방법：선택80례인단절단요추활탈접수요추후로감압、추체복위、추간식골융합、추궁근라정내고정수술병수혈치료적환자，기중예존자체혈회수적환자40례작위A조，인거절술전예존자체혈이수주이체혈적40례환자작위B조，기록병비교량조환자적수술시간、술중실혈량、술후인류량화수혈량、혈상규관찰지표（홍세포、혈홍단백、홍세포비용）급수혈상관불량반응。결과：량조적수술시간、술중실혈량、술후인류량화수혈량비교차이균무통계학의의（P>0.05）；량조불량반응비교차이유통계학의의（P<0.05）；량조수혈후제1천혈상규각관찰지표강저，여수혈전비교차이유통계학의의（P<0.05），량조간비교차이무통계학의의（P>0.05）；량조수혈후제7천혈상규각관찰지표비교차이균유통계학의의（P<0.05）。결론：대요추활탈수술환자래설，채용술전예존자체혈회수급이체수혈균능유효규정술중술후실혈성빈혈，단술전예존자체혈회수능강저수혈불량반응발생솔，수혈후환자혈상규각관찰지표회복경쾌，재당전이체혈공혈곤난적전제하，술전예존자체혈회수시일충치득림상추엄적방법。
To explore the clinical efficacy,adverse reaction and application value of predeposited autologous blood transfusion used in operation for lumbar spondylolisthesis.Method:80 patients with single segmental lumbar spondylolisthesis who had received posterior lumbar decompression,vertebral reduction,interbody fusion and pedicle screw internal fixation operation and transfusion therapy were selected,the 40patients who received autologous blood transfusion were set up the group A,at the same time,40 patients who refused to preoperative autologous blood were given allogeneic blood transfusion were set up the group B. The operation time,intraoperative blood loss,postoperative drainage volume,the volume of blood transfusion,blood routine indexes(red blood cell,hemoglobin,hematocrit) and the adverse transfusion reaction of two groups were compared. Result:The operation time,intraoperative blood loss,postoperative drainage volume and the volume of blood transfusion of two groups were compared,the differences were not statistically significant(P>0.05). Adverse reactions of two groups,the difference was statistically significant (P<0.05). First day after blood transfusion,the observed indexes of blood routine decreased,the difference before and after transfusion was statistically significant(P<0.05),but no statistically significant difference between the two groups (P>0.05). The red blood cell,hemoglobin,hematocrit of two groups in 7 days after transfusion were compared ot the two group,the difference were statistically significant(P<0.05).Conclusion:For patients with lumbar spondylolisthesis operation,the use of preoperative autologous blood and allogeneic blood can effectively correct postoperative blood loss anemia,but preoperative autologousblood can reduce the incidence of adverse transfusion reaction,the red blood cell, hemoglobin and hematocrit of patient recovery faster after autotransfusion.In the premise of the allogeneic blood supply difficulties,preoperative autologous blood transfusion is a method which is worthy of clinical application.