Nagano K, Yamanaka I, Tajiri O, Sakamoto M, Okada Y, Endo M, Saito S
Department of Anesthesiology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital.
Masui. 2000 Apr;49(4):417-9.
A 69-year-old woman with autoimmune hemolytic anemia (AIHA) received gastric resection and splenectomy under general anesthesia combined with epidural anesthesia. Her blood type had been determined as type A, Rh type CCDee, with anti-e-antibody and anti-pdl-antibody positive as autoantibodies. We applied the technique of hemodilutional autologous transfusion to supplement the blood loss during the operation to prevent hemolysis or occurrence of new antibody after homologous transfusion. We should pay much attention to a patient with AIHA to find signs of peri-operative hemolysis and to give the treatment for hemolysis in early stage. We consider that the hemodilutional autologous transfusion is a useful technique for the anesthetic management of the patient having a rare blood type.
一名69岁的自身免疫性溶血性贫血(AIHA)女性患者在全身麻醉联合硬膜外麻醉下接受了胃切除术和脾切除术。她的血型被确定为A型,Rh血型为CCDee,抗 - e抗体和抗 - pdl抗体作为自身抗体呈阳性。我们应用血液稀释自体输血技术来补充手术期间的失血,以防止溶血或异体输血后出现新抗体。对于AIHA患者,我们应格外留意,以发现围手术期溶血迹象并尽早进行溶血治疗。我们认为血液稀释自体输血是一种用于罕见血型患者麻醉管理的有用技术。