Jawan Bruno, Cheng Yu-Fan, Tseng Chia-Chi, Chen Yaw-Sen, Wang Chih-Chi, Huang Tung-Liang, Eng Hock-Liew, Liu Po-Ping, Chiu King-Wah, Wang Shih-Hor, Lin Chih-Che, Lin Tsan-Shiun, Liu Yueh-Wei, Chen Chao-Long
Department of Anesthesiology, Chang Gung Memorial Hospital, Kaoshiung Medical Center, Taiwan, China.
World J Gastroenterol. 2005 Jul 21;11(27):4233-6. doi: 10.3748/wjg.v11.i27.4233.
Autologous blood donation (ABD) is mainly used to reduce the use of banked blood. In fact, ABD can be regarded as acute blood loss. Would ABD 2-3 d before operation affect the CVP level and subsequently result in less blood loss during liver resection was to be determined.
Eighty-four patients undergoing living donor left hepatectomy were retrospectively divided as group I (GI) and group II (GII) according to have donated 250-300 mL blood 2-3 d before living donor hepatectomy or not. The changes of the intraoperative CVP, surgical blood loss, blood products used and the changes of perioperative hemoglobin (Hb) between groups were analyzed and compared by using Mann-Whitney U test.
The results show that the intraoperative CVP changes between GI (n = 35) and GII (n = 49) up to graft procurement were the same, subsequently the blood loss, but ABD resulted in significantly lower perioperative Hb levels in GI.
Since none of the patients required any blood products perioperatively, all the predonated bloods were discarded after the patients were discharged from the hospital. It indicates that ABD in current series had no any beneficial effects, in term of cost, lowering the CVP, blood loss and reduce the use of banked blood products, but resulted in significant lower Hb in perioperative period.
自体献血（ABD）主要用于减少库存血的使用。事实上，ABD可被视为急性失血。本研究旨在确定术前2 - 3天进行ABD是否会影响中心静脉压（CVP）水平，进而减少肝切除术中的失血量。
84例行活体供体左半肝切除术的患者，根据术前2 - 3天是否捐献250 - 300 mL血液，回顾性分为I组（GI）和II组（GII）。采用Mann - Whitney U检验分析比较两组患者术中CVP变化、手术失血量、血液制品使用情况以及围手术期血红蛋白（Hb）的变化。
结果显示，直至获取移植物时，GI组（n = 35）和GII组（n = 49）术中CVP变化相同，随后失血量也相同，但ABD导致GI组围手术期Hb水平显著降低。
由于所有患者围手术期均未需要任何血液制品，所有预存血液在患者出院后均被丢弃。这表明在本研究系列中，ABD在成本、降低CVP、减少失血量以及减少库存血液制品使用方面均无任何有益作用，反而导致围手术期Hb显著降低。
