Elawad A A, Fredin H O, Laurell M, Jonsson S
Department of Orthopaedics, Lund University, Malmö General Hospital, Sweden.
Med J Aust. 1991 Aug 5;155(3):147-50.
To follow the haematological response in elderly patients to preoperative autologous blood collection.
A prospective, randomised study.
Malmö General Hospital, Sweden.
Sixty patients with a mean age of 71 years (range, 60-82 years) who were to undergo total hip replacement were randomly divided into four groups of 15. One group served as control. Three units of blood were collected from patients in the other three groups, the first unit at least 30 days before the planned operation, with an average interval of 10 days between collections. Iron supplementation was given to one group as a substitution remedy, another group was given iron and folic acid and the third group was without supplementation during the collection period.
Haematological and biochemical tests were performed on blood samples taken at the time of each collection, on the morning of the hip replacement operation, and ten days after and six weeks after the operation.
No major complication was encountered with blood collection. The patients tolerated the procedure very well including the substitution remedies. Haematological and biochemical parameters remained within the normal range during the collection period and after the operation. No patient in the autologous groups needed homologous blood during the operation; three units of homologous blood were used after the operation in these patients.
Preoperative blood collection from the elderly is safe and well tolerated. The procedure should be encouraged in elective orthopaedic operations regardless of age.
观察老年患者术前自体采血后的血液学反应。
一项前瞻性随机研究。
瑞典马尔默综合医院。
60例平均年龄71岁(范围60 - 82岁)拟行全髋关节置换术的患者被随机分为四组,每组15例。一组作为对照组。其他三组患者采集3个单位的血液,第一个单位至少在计划手术前30天采集,采集间隔平均为10天。一组给予铁剂作为替代疗法,另一组给予铁剂和叶酸,第三组在采集期间不给予补充剂。
在每次采血时、髋关节置换手术当天早晨、术后10天和术后6周采集的血样上进行血液学和生化检测。
采血未出现重大并发症。患者对该过程耐受性良好,包括替代疗法。采集期间及术后血液学和生化参数均保持在正常范围内。自体血组患者术中均无需输注异体血;这些患者术后使用了3个单位的异体血。
老年患者术前采血安全且耐受性良好。无论年龄大小,在择期骨科手术中均应鼓励采用该方法。