Kuklo Timothy R, Owens Brett D, Polly David W
Department of Orthopaedic Surgery and Rehabilitation, Walter Reed Army Medical Center, 6900 Georgia Avenue, Washington, DC 20307, USA.
Spine J. 2003 Sep-Oct;3(5):388-93. doi: 10.1016/s1529-9430(02)00554-5.
Spinal deformity surgery, like many other orthopedic procedures, involves significant operative blood loss. In order to avoid the necessity of bank blood transfusions, many blood management strategies have been devised.
The goal of this review is to analyze the utility of current blood management strategies.
STUDY DESIGN/SETTING: Review paper.
Using Medline reviews, pertinent data on blood management agents and strategies were assembled.
Techniques can be organized into preoperative, intraoperative and postoperative categories. Preoperative techniques include autologous blood donation and red cell augmentation. In addition to some established surgical and anesthesia techniques, recent pharmacologic agents have become available to include thrombotic agents and antifibrinolytics, which surgeons may add to their intraoperative armamentarium. A brief mention of postoperative blood salvage drains is also included.
The judicious use of the agents and techniques can significantly reduce the need for blood transfusions in the setting of spinal deformity surgery.
脊柱畸形手术与许多其他骨科手术一样，术中会有大量失血。为避免输注库存血，人们设计了多种血液管理策略。
本综述旨在分析当前血液管理策略的效用。
研究设计/场所：综述文章。
通过检索医学文献数据库（Medline）综述，收集有关血液管理药物和策略的相关数据。
相关技术可分为术前、术中和术后三类。术前技术包括自体血捐献和红细胞增加。除了一些已确立的外科手术和麻醉技术外，近期出现的药物包括血栓形成剂和抗纤溶药物，外科医生可将其纳入术中可用手段。文中还简要提及了术后血液回收引流装置。
合理使用这些药物和技术可显著减少脊柱畸形手术中的输血需求。
