中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
23期
31-33,36
,共4页
脊柱手术%控制性降压%自体血回输
脊柱手術%控製性降壓%自體血迴輸
척주수술%공제성강압%자체혈회수
Spinal surgery%Controlled hypotension%Autologous blood transfusion
目的：探讨控制性降压复合自体血回输在大型脊柱手术中的应用效果。方法选取2012年8月~2014年3月在本院行大型脊柱手术的58例患者作为研究对象,随机分成对照组和观察组,各29例。对照组仅采用控制性降压处理,观察组采用控制性降压复合自体血回输,比较两组的效果。结果观察组的回收血量为(895±89)ml。两组的术中出血量比较,差异无统计学意义(P跃0.05)。观察组的异体输血量为(985±205)ml,显著少于对照组的(1960±245)ml,差异有统计学意义(P<0.05)。两组术后的PT和APTT水平显著高于术前,PLT水平显著低于术前,差异有统计学意义(P<0.05)。两组术后的PT、APTT、PLT水平比较,差异无统计学意义(P跃0.05)。两组手术前后的RBC水平比较,差异无统计学意义(P跃0.05)。两组术后的HCT和Hb水平显著低于术前,差异有统计学意义(P<0.05)。两组手术后的HCT和Hb水平比较,差异无统计学意义(P跃0.05)。结论在大型脊柱手术中采用控制性降压复合自体血回输能有效降低出血量,提高手术成功率,减少异体输血量,缓解医院血库的供血紧张问题,同时还避免了异体之间输血的免疫反应,不影响患者凝血功能,值得临床推广应用。
目的：探討控製性降壓複閤自體血迴輸在大型脊柱手術中的應用效果。方法選取2012年8月~2014年3月在本院行大型脊柱手術的58例患者作為研究對象,隨機分成對照組和觀察組,各29例。對照組僅採用控製性降壓處理,觀察組採用控製性降壓複閤自體血迴輸,比較兩組的效果。結果觀察組的迴收血量為(895±89)ml。兩組的術中齣血量比較,差異無統計學意義(P躍0.05)。觀察組的異體輸血量為(985±205)ml,顯著少于對照組的(1960±245)ml,差異有統計學意義(P<0.05)。兩組術後的PT和APTT水平顯著高于術前,PLT水平顯著低于術前,差異有統計學意義(P<0.05)。兩組術後的PT、APTT、PLT水平比較,差異無統計學意義(P躍0.05)。兩組手術前後的RBC水平比較,差異無統計學意義(P躍0.05)。兩組術後的HCT和Hb水平顯著低于術前,差異有統計學意義(P<0.05)。兩組手術後的HCT和Hb水平比較,差異無統計學意義(P躍0.05)。結論在大型脊柱手術中採用控製性降壓複閤自體血迴輸能有效降低齣血量,提高手術成功率,減少異體輸血量,緩解醫院血庫的供血緊張問題,同時還避免瞭異體之間輸血的免疫反應,不影響患者凝血功能,值得臨床推廣應用。
목적：탐토공제성강압복합자체혈회수재대형척주수술중적응용효과。방법선취2012년8월~2014년3월재본원행대형척주수술적58례환자작위연구대상,수궤분성대조조화관찰조,각29례。대조조부채용공제성강압처리,관찰조채용공제성강압복합자체혈회수,비교량조적효과。결과관찰조적회수혈량위(895±89)ml。량조적술중출혈량비교,차이무통계학의의(P약0.05)。관찰조적이체수혈량위(985±205)ml,현저소우대조조적(1960±245)ml,차이유통계학의의(P<0.05)。량조술후적PT화APTT수평현저고우술전,PLT수평현저저우술전,차이유통계학의의(P<0.05)。량조술후적PT、APTT、PLT수평비교,차이무통계학의의(P약0.05)。량조수술전후적RBC수평비교,차이무통계학의의(P약0.05)。량조술후적HCT화Hb수평현저저우술전,차이유통계학의의(P<0.05)。량조수술후적HCT화Hb수평비교,차이무통계학의의(P약0.05)。결론재대형척주수술중채용공제성강압복합자체혈회수능유효강저출혈량,제고수술성공솔,감소이체수혈량,완해의원혈고적공혈긴장문제,동시환피면료이체지간수혈적면역반응,불영향환자응혈공능,치득림상추엄응용。
Objective To explore the application effect of controlled hypotension combined with autologous blood trans-fusion in large spinal surgery. Methods 58 patients received large spinal surgery in our hospital from August 2012 to March 2014 were selected and randomly divided into the control group and the observation group,29 cases in each group.The control group was only given controlled hypotension,and the observation group was given controlled hypoten-sion combined with autologous blood transfusion.The effect in two groups was compared. Results The recycled blood volume in the observation group was (895±89) ml.There was no significant difference of the volume of bleeding during surgery in two groups (P>0.05).The allogenic transfusion volume in the observation group was (985±205) ml, which was less than (1960±245) ml in the control group,with significant difference(P<0.05).The level of PT and APTT after surgery in two groups was higher than that before surgery,and the level of PLT after surgery in two groups was lower than that be-fore surgery,with significant difference(P<0.05).There was no significant difference of the level of PT,APTT and PLT af-ter surgery in two groups(P>0.05).The level of preoperative and postoperative RBC in two groups was no significant in two groups(P>0.05).The level of HCT and Hb after surgery in two groups was lower than that before surgery,with significant difference(P<0.05).There was no significant difference of the level of HCT and Hb after surgery in two groups(P>0.05). Conclusion The application of controlled hypotension combined with autologous blood transfusion in large spinal surgery can effectively reduce volume of bleeding,improve successful rate of surgery,reduce allogenic transfusion volume,allevi-ate blood supply tension in hospital blood bank,and avoid the immunological reaction between allogenic transfusion at the same time,without influencing patients’coagulation function,it is worthy of clinical promotion and application.
