Loughenbury Peter R, Berry Lyeanda, Brooke Ben T, Rao Abhay S, Dunsmuir Robert A, Millner Peter A
Peter R Loughenbury, Lyeanda Berry, Ben T Brooke, Abhay S Rao, Robert A Dunsmuir, Peter A Millner, Department of Neurosciences, Leeds General Infirmary, Leeds LS1 3EX, United Kingdom.
World J Orthop. 2016 Dec 18;7(12):808-813. doi: 10.5312/wjo.v7.i12.808.
To investigate whether autologous blood transfusion (ABT) drains and intra-operative cell salvage reduced donor blood transfusion requirements during scoliosis surgery.
Retrospective data collection on transfusion requirements of patients undergoing scoliosis surgery is between January 2006 and March 2010. There were three distinct phases of transfusion practice over this time: Group A received "traditional treatment" with allogeneic red cell transfusion (ARCT) in response to an intra- or post-operative anaemia (Hb < 8 g/dL or a symptomatic anaemia); Group B received intra-operative cell salvage in addition to "traditional treatment". In group C, ABT wound drains were used together with both intra-operative cell salvage and "traditional treatment".
Data from 97 procedures on 77 patients, there was no difference in mean preoperative haemoglobin levels between the groups (A: 13.1 g/dL; B: 13.49 g/dL; C: 13.66 g/dL). Allogeneic red cell transfusion was required for 22 of the 37 procedures (59%) in group A, 17 of 30 (57%) in group B and 16 of 30 (53%) in group C. There was an overall 6% reduction in the proportion of patients requiring an ARCT between groups A and C but this was not statistically significant (χ = 0.398). Patients in group C received fewer units (mean 2.19) than group B (mean 2.94) ( = 0.984) and significantly fewer than those in group A (mean 3.82) ( = 0.0322). Mean length of inpatient stay was lower in group C (8.65 d) than in groups B (12.83) or A (12.62).
When used alongside measures to minimise blood loss during surgery, ABT drains and intra-operative cell salvage leads to a reduced need for donor blood transfusion in patients undergoing scoliosis surgery.
探讨自体输血（ABT）引流管及术中血液回收是否能减少脊柱侧弯手术中异体输血需求。
回顾性收集2006年1月至2010年3月期间接受脊柱侧弯手术患者的输血需求数据。在此期间有三个不同阶段的输血实践：A组接受“传统治疗”，即根据术中或术后贫血情况（血红蛋白<8 g/dL或有症状性贫血）进行异体红细胞输血（ARCT）；B组除“传统治疗”外还接受术中血液回收；C组使用ABT伤口引流管，并同时进行术中血液回收及“传统治疗”。
77例患者共97例手术的数据显示，各组术前平均血红蛋白水平无差异（A组：13.1 g/dL；B组：13.49 g/dL；C组：13.66 g/dL）。A组37例手术中有22例（59%）需要异体红细胞输血，B组30例中有17例（57%），C组30例中有16例（53%）。A组和C组之间需要ARCT的患者比例总体降低了6%，但无统计学意义（χ = 0.398）。C组患者接受的输血单位数（平均2.19单位）少于B组（平均2.94单位）（ = 0.984），且显著少于A组（平均3.8单位）（ = 0.0322）。C组的平均住院时间（8.65天）低于B组（12.83天）和A组（12.62天）。
在脊柱侧弯手术中，当与减少术中失血的措施一起使用时，ABT引流管及术中血液回收可减少患者对异体输血的需求。
