Akgül Turgut, Dikici Fatih, Ekinci Mehmet, Buget Mehmet, Polat Gökhan, Sar Cüneyt
Department of Orthopedics and Traumatology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.
Department of Anesthesiology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.
Acta Orthop Traumatol Turc. 2014;48(3):303-6. doi: 10.3944/AOTT.2014.13.0146.
The aim of the study was to evaluate the efficacy of the intraoperative blood salvage cell saver method for allogeneic blood transfusion in the surgical treatment of adolescent idiopathic scoliosis with pedicle screw and rod combination.
The study included 33 patients (5 males and 28 females) who underwent surgery due to adolescent idiopathic scoliosis. Patients were divided into 2 groups; 16 patients (mean age: 17.1±3.9 years) in Group A were operated using the cell saver (Medtronic Autolog; autologous cell saver machine) method and the 17 patients (mean age 18.7±6.8 years) in Group B (control group) were treated without cell saver. The Cobb angle, levels of pedicle fixation, operation time, postoperative bleeding, hemoglobin change, allogeneic blood replacement and the amount of autologous erythrocytes were recorded.
Mean level of pedicle fixation was 12.9±1.54 vertebra using a mean of 21.1±3.21 screws in Group A and 12.8±1.47 vertebra using 18.7±3.59 screws in Group B (p>005). The mean operation time was 224 (Group A: 228±58; Group B: 221±60) minutes. There were no statistically significant differences in the demographic characteristics of both groups (p>0.05). The preoperative mean hemoglobin levels were 12.2±1.47 mg/dl in Group A and 13.1±1.56 mg/dl in Group B. Postoperative mean hemoglobin level was 11.3±1.62 mg/dl in Group A and 9.86±0.93 mg/dl in Group B (p=0.004). The mean amount of autologous erythrocyte replacement was 284±139 ml. The mean postoperative bleeding was 834±253 ml in Group A and 759±380 ml in Group B (p>0.05). The mean allogeneic blood replacement was 1.88±0.88 units in Group A and 1.94±1.34 in Group B (p>0.05).
Autologous erythrocyte replacement was possible using the cell saver method. However, there was no decrement in allogeneic blood replacement using cell saver in the surgical treatment of adolescent idiopathic scoliosis.
本研究旨在评估术中血液回收细胞保存法在青少年特发性脊柱侧凸椎弓根螺钉与棒联合手术治疗中异体输血的疗效。
本研究纳入33例因青少年特发性脊柱侧凸接受手术的患者（5例男性，28例女性）。患者分为2组；A组16例患者（平均年龄：17.1±3.9岁）采用细胞保存器（美敦力自体血液回收机）方法进行手术，B组（对照组）17例患者（平均年龄18.7±6.8岁）未使用细胞保存器进行治疗。记录Cobb角、椎弓根固定节段、手术时间、术后出血、血红蛋白变化、异体血置换量和自体红细胞量。
A组平均椎弓根固定节段为12.9±1.54个椎体，平均使用21.1±3.21枚螺钉；B组平均为12.8±1.47个椎体，使用18.7±3.59枚螺钉（p>0.05）。平均手术时间为224分钟（A组：228±58分钟；B组：221±60分钟）。两组的人口统计学特征无统计学显著差异（p>0.05）。A组术前平均血红蛋白水平为12.2±1.47mg/dl，B组为13.1±1.56mg/dl。A组术后平均血红蛋白水平为11.3±1.62mg/dl，B组为9.86±0.93mg/dl（p=0.004）。自体红细胞置换的平均量为284±139ml。A组术后平均出血量为834±253ml，B组为759±380ml（p>0.05）。A组异体血置换平均量为1.88±0.88单位，B组为1.94±1.34单位（p>0.05）。
使用细胞保存器方法可以进行自体红细胞置换。然而，在青少年特发性脊柱侧凸的手术治疗中，使用细胞保存器并未减少异体血置换量。
