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脊柱畸形手术矫正中术中细胞回收的经验:124例患者的回顾性研究

Experience of Intraoperative Cell Salvage in Surgical Correction of Spinal Deformity: A Retrospective Review of 124 Patients.

作者信息

Yang Changsheng, Wang Jianru, Zheng Zhaomin, Zhang Zhongmin, Liu Hui, Wang Hua, Li Zemin

机构信息

From the Academy of Orthopedics (CY, ZZ), Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University; Department of Spine Surgery (CY, JW, Zhaomin Zheng, HL, HW, ZL), The First Affiliated Hospital, Sun Yat-sen University; Pain Research Centre (Zhaomin Zheng), Sun Yat-sen University, Guangzhou, 510000, China.

出版信息

Medicine (Baltimore). 2016 May;95(21):e3339. doi: 10.1097/MD.0000000000003339.

Abstract

The effect of intraoperative cell salvage (ICS) in surgical correction of spinal deformity remained controversial. This study was to quantitatively demonstrate its effect. In all, 124 patients having ICS in surgical correction of spinal deformity were included. These patients would be divided into 3 groups. Group 1-blood loss less than 15 mL/kg; group 2-between 15 and 37.5 mL/kg; and group 3-more than 37.5 mL/kg. The mean blood loss was 37.2 mL/kg and patients received 872.2 mL salvaged blood on average. The prevalence of intraoperative transfusion of allogenic RBC was 62.9% and the amount averaged 3.4 U. In groups 1 to 3, the prevalence of intraoperative allogenic transfusion was 23.5%, 66.7%, and 100%, respectively. Logistic analysis showed blood loss minus autotransfusion was of significance in predicting intraoperative transfusion, whereas the blood loss or autotransfusion alone was not, implicating an important role of ICS in saving allogenic RBC. The maximum decrease of hemoglobin after operation occurred in the third day, and the magnitude was 45.7 g/L. No severe complications related to ICS were observed. In summary, ICS could decrease the amount of allogenic transfusion in surgical correction of spinal deformity. However, in terms of reducing prevalence of allogenic transfusion, it had a protective effect only in patients with small blood loss.

摘要

术中自体血回输(ICS)在脊柱畸形手术矫正中的效果仍存在争议。本研究旨在定量证明其效果。总共纳入了124例行脊柱畸形手术矫正且采用ICS的患者。这些患者将被分为3组。第1组——失血量小于15毫升/千克;第2组——失血量在15至37.5毫升/千克之间;第3组——失血量超过37.5毫升/千克。平均失血量为37.2毫升/千克,患者平均接受872.2毫升回输血液。术中输注异体红细胞的发生率为62.9%,平均输注量为3.4单位。在第1至3组中,术中异体输血的发生率分别为23.5%、66.7%和100%。逻辑分析表明,失血量减去自体回输量对预测术中输血具有显著意义,而单独的失血量或自体回输量则无显著意义,这表明ICS在节省异体红细胞方面发挥着重要作用。术后血红蛋白的最大降幅出现在第三天,降幅为45.7克/升。未观察到与ICS相关的严重并发症。总之,ICS可减少脊柱畸形手术矫正中的异体输血量。然而,就降低异体输血发生率而言,它仅对失血量少的患者有保护作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d99/4902333/08a2d0ab53bc/medi-95-e3339-g005.jpg

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