Tripković Branko, Buković Damir, Sakić Katarina, Sakić Sime, Buković Nevia, Radaković Branko
Department of Orthopaedic Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.
Coll Antropol. 2008 Mar;32(1):153-60.
Several methods have been found to be successful in reducing the need for allogeneic transfusion among the patients undergoing total hip replacement. The purpose of this prospective study was to analyse the quality and evaluate the effect of postoperative autotransfusion on the need for allogeneic transfusion following total hip replacement. The prospective study was performed in two groups of patients undergoing total hip replacement. Before the operative procedure all patients in both groups predonated two doses of autologous blood. In GROUP 1. the system for postoperative collection and transfusion of shed blood was used. In GROUP 2. the patients underwent total hip replacement without blood salvage system. Standard suction collection sets were used postoperatively. In this group shed blood was not transfused to the patients. The samples of preoperative donated autologus blood, allogeneic blood and postoperative collected autologous blood were analysed for number of red cells, hemoglobin, hematocrit, platelets, white blood cells, values of potassium, sodium, free hemoglobin and acid base status. The postoperatively blood salvage significantly reduced the use of allogeneic transfusion among patients managed with total hip replacement (allogeneic transfusion received 12% patients in Group 1 and 80% patients in Group 2; p<0.001). The values of red blood cells are significantly lower in postoperative collected autotransfusion blood compared with preoperative collected autologous blood and allogeneic blood (p<0.001). The values of potassium and acid base status were in normal range in postoperatively collected autotransfusion blood. These values in preoperatively collected autologous blood and allogeneic blood were out of normal range; (p<0.001). In addition to reducing the risk of complications that are associated with allogeneic transfusion, postoperative blood salvage may offer benefits including reducing the need for allogeneic blood. Our study confirmed that postoperative collection and transfusion of drainaged blood is simple and safe method that significantly reduce the need for allogeneic transfusion in patients underwent total hip replacement. The blood collected and transfused postoperatively has lower values of red blood cells and normal values of potassium and acid base balance. The transfusion of this blood caused no complications in our patients.
已经发现几种方法成功减少了全髋关节置换患者的异体输血需求。这项前瞻性研究的目的是分析术后自体输血的质量，并评估其对全髋关节置换术后异体输血需求的影响。前瞻性研究在两组接受全髋关节置换的患者中进行。手术前，两组所有患者均预先捐献两剂自体血。在第1组中，使用术后收集和回输失血的系统。在第2组中，患者在没有血液回收系统的情况下接受全髋关节置换。术后使用标准吸引收集装置。在该组中，失血未回输给患者。对术前捐献的自体血、异体血和术后收集的自体血样本进行红细胞、血红蛋白、血细胞比容、血小板、白细胞、钾值、钠值、游离血红蛋白和酸碱状态分析。术后血液回收显著减少了接受全髋关节置换患者的异体输血使用（第1组12%的患者接受异体输血，第2组80%的患者接受异体输血；p<0.001）。与术前收集的自体血和异体血相比，术后收集的自体输血红细胞值显著降低（p<0.001）。术后收集的自体输血血钾值和酸碱状态在正常范围内。术前收集的自体血和异体血中的这些值超出正常范围；（p<0.001）。除了降低与异体输血相关的并发症风险外，术后血液回收还可能带来包括减少异体血需求在内的益处。我们的研究证实术后收集和回输引流血是一种简单安全的方法，可显著减少全髋关节置换患者的异体输血需求。术后收集和回输的血液红细胞值较低，血钾值和酸碱平衡正常。输注这种血液在我们的患者中未引起并发症。
