CAJ | 학술논문

目的评价游离血红蛋白(fHb)、K+和Ca2+清除率床旁快速评估回收血清除率的可靠性.方法拟行自体血回收-回输技术的外科手术患者26例,年龄18～ 80岁,BMI＜32 kg/m2,性别不限,ASA分级Ⅰ-Ⅲ级,采用CATS型血液回收机回收术野出血.分别检测大流量、标准、高质量3种清洗模式下白蛋白(Alb)、fHb、K+和Ca2+的清除率.结果与Alb清除率比较,3种清洗模式下K+清除率(＜90％)和Ca2+清除率降低(差值＜5％),大流量清洗模式下fHb清除率降低(差值＜5％)(P＜0.01),标准和高质量清洗模式下差异无统计学意义(P＞0.05).不同清洗模式之间各指标清除率比较差异无统计学意义(P＞0.05).结论采用CATS型自体血回收机进行血液回收时,Ca2+和fHb清除率可作为床旁快速评估回收血清除率的指标,而Ca2+因其检测更加方便,较fHb更具优越性.
목적 평개유리혈홍단백(fHb)、K+화Ca2+청제솔상방쾌속평고회수혈청제솔적가고성.방법 의행자체혈회수-회수기술적외과수술환자26례,년령18～ 80세,BMI＜32 kg/m2,성별불한,ASA분급Ⅰ-Ⅲ급,채용CATS형혈액회수궤회수술야출혈.분별검측대류량、표준、고질량3충청세모식하백단백(Alb)、fHb、K+화Ca2+적청제솔.결과 여Alb청제솔비교,3충청세모식하K+청제솔(＜90％)화Ca2+청제솔강저(차치＜5％),대류량청세모식하fHb청제솔강저(차치＜5％)(P＜0.01),표준화고질량청세모식하차이무통계학의의(P＞0.05).불동청세모식지간각지표청제솔비교차이무통계학의의(P＞0.05).결론 채용CATS형자체혈회수궤진행혈액회수시,Ca2+화fHb청제솔가작위상방쾌속평고회수혈청제솔적지표,이Ca2+인기검측경가방편,교fHb경구우월성.
Objective To evaluate the reliability of the clearance rates of free hemoglobin (fHb), K+ and Ca22+ for rapid bedside evaluation of the clearance rates of the salvaged blood.Methods Twenty-six patients of both sexes, aged 18-80 yr, with body mass index＜32 kg/m22, of American Society of Anesthesiologists physical status [-Ⅲ, scheduled for elective surgery requiring autologous blood withdrawalreinfusion, were involved in this study.An autotransfusion device (continuous autotransfusion system, Fresenius) was used to collect the blood shed from the surgical field and to process the salvaged blood during the surgery.The clearance rates of albumin (Alb) , fHb, K+ and Ca22+ were detected in three washing modes (big flux, standard, high quality).Results Compared with the clearance rate of Alb, the clearance rates of K+ (＜90％) and Ca2+ were significantly decreased in three washing modes (the difference ＜5％) , the clearance rate of fHb was decreased in the big flux washing mode (the difference ＜5％) (P＜0.05), and no significant change was found in the clearance rate of fHb in the standard and high quality washing modes (P＞0.05).There was no significant difference in the clearance rates of each parameter between the three washing modes (P ＞ 0.05).Conclusion When the autotransfusion device continuous autotransfusion system is used to collect the blood, the clearance rates of flHb and Ca2+ can be used as parameters for rapid bedside evaluation of the clearance rates of the salvaged blood, while Ca2 +detection is more convenient, and therefore it is superior to fHb.