Péterffy A, Horváth G, Tamás C, Bodnár F, Szokol M, Vaszily M
Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Altalános Orvostudományi Kar, Szívsebészeti Klinika.
Orv Hetil. 2000 Apr 30;141(18):959-61.
The religious community Jehovah's Witnesses was founded in 1870. They hold that blood transfusion is against God's law. Surgical treatment of a Jehova witness is a great challenge for every surgeon, especially for cardiac surgeons because blood transfusion is frequently needed during such operations. Authors have been trying to reduce the utilization of preserved blood for ten years. This study is about the experience with Jehovah's Witnesses who have undergone open heart surgery in Debrecen. Twenty-four patients underwent open heart surgery from 1989 till May 1999. 7 of them were males and 17 were females. The mean age was 53 years (40-70 yrs). Three patients had congenital heart disease, 11 had acquired valve disease and 7 had coronary stenosis. In 3 cases the patients had combined coronary and valve disease. Authors used a complete procedure for reducing blood loss during the operations. Two patients (8.3%) died during the early postoperative period. Preoperative mean haemoglobin level was 134.2 g/l (112-166) and haematocrit value varied between 36-50% (mean 38%). On the first postoperative day significant decrease was registrated in these values. From the second day a slow but significant increase of haemoglobin and haematocrit levels were detected. The mean follow up time was 37.6 months (2-144), and the NYHA classification of 21 longtime survivors improved from 3.06 to 1.62. At the Department of Cardiac Surgery in Debrecen as well as worldwide more and more operations are done without blood or preserved blood products, so it could be said that nowadays surgical treatment of Jehovah's Witnesses has lower risk than before.
耶和华见证人宗教团体成立于1870年。他们认为输血违背上帝的律法。对耶和华见证人进行外科治疗对每位外科医生来说都是巨大的挑战，尤其是对心脏外科医生而言，因为这类手术中经常需要输血。十年来，作者们一直在努力减少库存血的使用。本研究是关于在德布勒森接受心脏直视手术的耶和华见证人的经验。从1989年到1999年5月，有24例患者接受了心脏直视手术。其中7例为男性，17例为女性。平均年龄为53岁（40 - 70岁）。3例患者患有先天性心脏病，11例患有后天性瓣膜病，7例患有冠状动脉狭窄。3例患者同时患有冠状动脉和瓣膜疾病。作者采用了一套完整的手术中减少失血的程序。2例患者（8.3%）在术后早期死亡。术前平均血红蛋白水平为134.2 g/l（112 - 166），血细胞比容值在36% - 50%之间（平均38%）。术后第一天这些值显著下降。从第二天起，血红蛋白和血细胞比容水平缓慢但显著上升。平均随访时间为37.6个月（2 - 144个月），21例长期存活者的纽约心脏协会（NYHA）分级从3.06改善到1.62。在德布勒森心脏外科以及全球范围内，越来越多的手术在不使用血液或库存血制品的情况下进行，所以可以说如今对耶和华见证人进行外科治疗的风险比以前更低了。
