CAJ | 학술논문

目的：：观察术中自体血回输技术对脊柱外科患者炎性反应、凝血功能及其他并发症的影响。方法：选择择期预计出血量超过600 ml,全麻下拟行脊柱手术的患者60例,采用随机数字表法均分为自体血液回输组( A组)和异体输血组( B组)。记录2组患者自体或异体输血前、输血后1 h( T2)、24 h( T3)、48 h( T4)、72 h( T5)动脉血气分析和凝血功能,并采用放射免疫法测定白细胞介素( IL)-6和IL-10。观察术后感染、切口愈合情况和住院时间。结果：A组自体血液回输后T2~T5时点IL-6水平均明显低于B组(P<0.01),而IL-10均低于B组(P<0.01)；2组输血后不同时点血红蛋白和凝血功能差异均无统计学意义(P>0.05)。 A组患者术后无任何相关输血并发症的发生,切口愈合良好,手术后住院时间较B组明显缩短(P<0.01)。结论：脊柱手术中使用自体血回输技术,可明显减轻IL-6和IL-10等炎症因子水平的改变,减少患者手术后并发症,达到快速康复的目的。
목적：：관찰술중자체혈회수기술대척주외과환자염성반응、응혈공능급기타병발증적영향。방법：선택택기예계출혈량초과600 ml,전마하의행척주수술적환자60례,채용수궤수자표법균분위자체혈액회수조( A조)화이체수혈조( B조)。기록2조환자자체혹이체수혈전、수혈후1 h( T2)、24 h( T3)、48 h( T4)、72 h( T5)동맥혈기분석화응혈공능,병채용방사면역법측정백세포개소( IL)-6화IL-10。관찰술후감염、절구유합정황화주원시간。결과：A조자체혈액회수후T2~T5시점IL-6수평균명현저우B조(P<0.01),이IL-10균저우B조(P<0.01)；2조수혈후불동시점혈홍단백화응혈공능차이균무통계학의의(P>0.05)。 A조환자술후무임하상관수혈병발증적발생,절구유합량호,수술후주원시간교B조명현축단(P<0.01)。결론：척주수술중사용자체혈회수기술,가명현감경IL-6화IL-10등염증인자수평적개변,감소환자수술후병발증,체도쾌속강복적목적。
Objective:To observe the effects of intraoperative autotransfusion on the inflammatory reaction,coagulation function and other complications of spine surgery patients. Methods:Sixty spine surgery patients,whose haemorrhage amount was expected to more than 600 ml,were randomly divided into the autotransfusion group( group A) and allogeneic transfusion group( group B) using a random number table(30 cases in each group). Arterial blood gas analysis,coagulation function and the levels of interleukin-6 and -10(IL-6 and -10) detected by radioimmunoassay in two groups were recorded before transfusion,after 1 h(T2),24 h(T3),48 h(T4) and 72 h (T5) of transfusion. The postoperative infection,wound healing and hospitalization days in two groups were observed after operation. Results:The levels of IL-6 and IL-10 in group A at T2 to T5 were significantly lower than those in group B(P<0. 01). The differences of Hemoglobin and coagulation function after transfusion between two groups were not statistically significant(P>0. 05). Compared with group B,no postoperative transfusion complication,good wound healing and short hospitalization days were found in group A(P <0. 01). Conclusions:The intraoperative autotransfusion can obviously reduce the levels of IL-6 and IL-10 and postoperative complication,and promote rapid recovery in spine surgery patients.