心脏直视手术后纵隔引流血的自体输血

Autotransfusion of shed mediastinal blood after open heart surgery.

作者信息

Zhao Kangli, Xu Jianping, Hu Shengshou, Wu Qingyu, Wei Yizhen, Liu Yinglong

机构信息

Department of Cardiac Surgery, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100037, China.

出版信息

Chin Med J (Engl). 2003 Aug;116(8):1179-82.

PMID:12935406

Abstract

OBJECTIVE

To determine the safety and effectiveness of autotransfusion of shed mediastinal blood after open heart surgery.

METHODS

Sixty patients undergoing coronary artery bypass grafting (CABG) were selected randomly to receive either nonwashed shed mediastinal blood (Group 1, n = 30) or banked blood (Group 2, n = 30). Drainage and transfusion volume were determined after the operation. Hb, RBC, HCT and PLT were detected immediately before and after the operation, as well as 24 hours and 7 days after the operation. Data were analyzed using Fisher's exact test. A P < 0.05 was considered significant.

RESULTS

There were no significant differences in Hb, HCT, PLT or length of cardiopulmonary bypass (CPB) (P > 0.05). In the two groups, no significant difference in the mean blood loss was observed during 24 hours after the operation (660 +/- 300 ml in Group 1 and 655 +/- 280 ml in Group 2, P > 0.05). In Group 1, the mean volume autotransfused was 280 +/- 160 ml, and the patients required 360 +/- 80 ml banked blood compared with 660 +/- 120 ml in Group 2. In other words, the banked blood requirement in Group 1 was 40% lower.

CONCLUSIONS

Autotransfusion of shed mediastinal blood after an open heart operation is safe and effective.

摘要

目的

确定心脏直视手术后自体回输纵隔引流血的安全性和有效性。

方法

随机选择60例行冠状动脉旁路移植术（CABG）的患者，分别接受未洗涤的纵隔引流血（第1组，n = 30）或库存血（第2组，n = 30）。术后测定引流量和输血量。在术前、术后即刻、术后24小时和7天检测血红蛋白（Hb）、红细胞（RBC）、血细胞比容（HCT）和血小板（PLT）。采用Fisher精确检验分析数据。P < 0.05被认为具有统计学意义。

结果

两组患者的Hb、HCT、PLT或体外循环（CPB）时间无显著差异（P > 0.05）。两组术后24小时内平均失血量无显著差异（第1组为660±300 ml，第2组为655±280 ml，P > 0.05）。第1组平均自体回输量为280±160 ml，患者需要360±80 ml库存血，而第2组为660±120 ml。换言之，第1组的库存血需求量低40%。