CAJ | 학술논문

目的高龄手术患者对于术中失血耐受性较差,因此常需术中或术后输入异体血,其危险性包括溶血反应及输血感染,使用术中自体血回输可减少异体血输入从而避免这些风险.本研究的目的在于评估高龄患者颈后路单开门榷管成形术中应用自体血回输的效果.方法本研究回顾了2010年至2013年间行颈后路单开门椎管成形术的患者(年龄＞60岁)583例,其中应用术中自体血回输患者231例(A组),未应用术中自体血回输352例(B组).该研究评估患者围术期异体血使用量及术后第1、3、5天血红蛋白水平.结果 A组术中自体血回输(263±27)ml.术中患者异体血使用量A组小于B组,但是差异未见统计学意义(P＞0.05).术后两组异体血使用量比较差异未见统计学意义(P＞0.05).A组血红蛋白水平在术后第1天及第3天均明显高于B组(P均＜0.05),两组术后第5天血红蛋白水平比较差异未见统计学意义(P＞0.05).结论术中自体血回输可减少围术期异体血输血量,提高术后患者血红蛋白水平,降低术后并发症风险.术中自体血回输对于行颈后路单开门椎管成形术的高龄患者是一种安全、有效的技术.
목적 고령수술환자대우술중실혈내수성교차,인차상수술중혹술후수입이체혈,기위험성포괄용혈반응급수혈감염,사용술중자체혈회수가감소이체혈수입종이피면저사풍험.본연구적목적재우평고고령환자경후로단개문각관성형술중응용자체혈회수적효과.방법 본연구회고료2010년지2013년간행경후로단개문추관성형술적환자(년령＞60세)583례,기중응용술중자체혈회수환자231례(A조),미응용술중자체혈회수352례(B조).해연구평고환자위술기이체혈사용량급술후제1、3、5천혈홍단백수평.결과 A조술중자체혈회수(263±27)ml.술중환자이체혈사용량A조소우B조,단시차이미견통계학의의(P＞0.05).술후량조이체혈사용량비교차이미견통계학의의(P＞0.05).A조혈홍단백수평재술후제1천급제3천균명현고우B조(P균＜0.05),량조술후제5천혈홍단백수평비교차이미견통계학의의(P＞0.05).결론 술중자체혈회수가감소위술기이체혈수혈량,제고술후환자혈홍단백수평,강저술후병발증풍험.술중자체혈회수대우행경후로단개문추관성형술적고령환자시일충안전、유효적기술.
Objective To assess the effect of autologous blood transfusion on elderly patients underwent laminoplasty by expanding vertebral canal through posterior approach.Methods The study reviewed 583 patients (above 60 years old)underwent laminoplasty by expanding vertebral canal through posterior approach from 2010 to 2013,of which 231 patients (group A) used intraoperative autologous blood transfusion,and 352 patients (group B) did not.The allogeneic blood usage and postoperative hemoglobin levels on the first,third and fifth day after sugery was evaluated.Results The transfused intraoperative autologous blood volume in group A was (263 ± 27)ml.Group A used less allogeneic blood intraoperative than group B,but there was no significant difference (P ＞ 0.05).The usage of allogeneic blood postoperative between the two group had no statistical significance(P ＞ 0.05).Hemoglobin levels of group A on the first day and third day after operation were significantly higher than that in group B (all P ＜0.05),the postoperative hemoglobin levels on fifth day after operation showed no statistica significance.Conclusions Intraoperative autologous blood transfusion can reduce the amount of allogeneic blood transfusion perioperative,improve postoperative hemoglobin levels,and reduce the risk of postoperative complications.The intraoperative autologous blood transfusion for elderly patients underwent laminoplasty by expanding vertebral canal through posterior approach is a safe and effective technique.