Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 40202, USA.
Spine (Phila Pa 1976). 2013 Feb 15;38(4):E217-22. doi: 10.1097/BRS.0b013e31827f044e.
Retrospective review.
To identify risk factors for cell saver transfusion in lumbar spinal surgery and determine if cell saver transfusions affected intraoperative or postoperative transfusion rates.
Cell saver has been used to minimize allogeneic blood transfusion in lumbar spinal surgery. Conflicting reports exist, which call into question the efficacy of cell saver use.
We reviewed medical records of randomly selected patients who underwent posterolateral fusion with or without transforaminal interbody fusion from July 2010 to June 2011. Transfusion rates and transfusion-related complications were determined. Binary logistic regression was performed to identify risk factors for use of autologous cell saver transfusion.
There were 178 females and 107 males, with a mean age of 57.2 years. Of the 285 cases, 39 had no cell saver available, 147 had cell saver available but no autologous blood was recovered or transfused and 99 had an autologous cell saver transfusion. Patients who had cell saver transfusion had a higher rate of intraoperative allogeneic blood transfusion (52%) compared with those who did not (22%). There was no significant difference in the rate of postoperative transfusions or transfusion-related reactions between patients who did and did not have cell saver transfusion. Patient's age, smoking status, American Society of Anesthesiologists grade, use of anticoagulants preoperatively, primary or revision surgery, iliac crest bone graft harvest, anesthesiologist, or surgeon had no significant effect on cell saver infusion. Body mass index (odds ratio [OR] = 1.06), number of posterolateral fusion levels fused (OR = 2.50), and number of transforaminal interbody fusions performed (OR = 2.41) were independent risk factors for the use of autologous cell saver transfusion.
Body mass index, multi-level fusion and transforaminal interbody fusion result in increased use of autologous cell saver transfusion in lumbar spinal surgery. Use of autologous cell saver transfusion did not reduce the requirement for intraoperative or postoperative allogeneic blood transfusion.
回顾性研究。
确定腰椎手术中使用细胞保存器输血的风险因素，并确定细胞保存器输血是否影响术中或术后输血率。
细胞保存器已被用于减少腰椎脊柱手术中的同种异体输血。存在相互矛盾的报告，这使得细胞保存器使用的疗效受到质疑。
我们回顾性分析了 2010 年 7 月至 2011 年 6 月间行后路外侧融合术（或联合经椎间孔椎间融合术）的随机选择患者的病历。确定输血率和输血相关并发症。采用二项逻辑回归分析识别使用自体细胞保存器输血的风险因素。
共有 178 名女性和 107 名男性，平均年龄为 57.2 岁。在 285 例患者中，有 39 例无细胞保存器，147 例有细胞保存器但未回收或输注自体血，99 例有自体细胞保存器输血。接受细胞保存器输血的患者术中异体输血率（52%）高于未接受细胞保存器输血的患者（22%）。接受细胞保存器输血和未接受细胞保存器输血的患者术后输血率或输血相关反应无显著差异。患者年龄、吸烟状况、美国麻醉师协会分级、术前使用抗凝剂、初次或翻修手术、髂嵴骨移植采集、麻醉师或外科医生对细胞保存器输注无显著影响。体重指数（比值比[OR] = 1.06）、后路融合节段数（OR = 2.50）和经椎间孔椎间融合术数（OR = 2.41）是自体细胞保存器输血的独立危险因素。
体重指数、多节段融合和经椎间孔椎间融合术导致腰椎脊柱手术中自体细胞保存器输血增加。使用自体细胞保存器输血并未减少术中或术后异体输血的需求。
2。
