Bovill D F, Norris T R
Department of Orthopaedic Surgery, University of California School of Medicine, San Francisco.
Clin Orthop Relat Res. 1989 Mar(240):137-40.
Perioperative blood loss associated with 36 cases of major shoulder surgery in which an intraoperative autologous transfusion device was used was compared with a control group of 36 shoulder surgery patients to determine the effectiveness of intraoperative autologous transfusion (IAT). Total blood loss in this retrospective review was evaluated by assessing the volume of transfused banked blood and the change in hematocrit. All surgical cases were performed by the same surgeon. The procedures considered in the study were humeral head and total shoulder replacement. Use of an intraoperative autotransfusion device was associated with fewer units of transfused banked blood and similar or smaller drops in hematocrit. While shoulder surgery can involve substantial blood loss, the authors recommend intraoperative autologous transfusion for revision of failed shoulder surgery, arthrodesis, joint replacement, or repairs of massive cuff tears when mobilization and tendon transfers are anticipated. The risk of disease transmission through banked blood, especially of acquired immune deficiency syndrome (AIDS) and hepatitis viruses, has increased the need for a heightened awareness and use of alternative blood sources such as IAT.
将使用术中自体输血装置的36例肩部大手术患者的围手术期失血量与36例肩部手术患者的对照组进行比较，以确定术中自体输血（IAT）的有效性。在这项回顾性研究中，通过评估输注库存血的量和血细胞比容的变化来评估总失血量。所有手术病例均由同一位外科医生进行。该研究中考虑的手术包括肱骨头置换和全肩关节置换。使用术中自体输血装置与输注的库存血单位数减少以及血细胞比容相似或更小的下降有关。虽然肩部手术可能会导致大量失血，但作者建议在预计需要进行活动和肌腱转移时，对失败的肩部手术翻修、关节融合术、关节置换或巨大肩袖撕裂修复采用术中自体输血。通过库存血传播疾病的风险，尤其是获得性免疫缺陷综合征（AIDS）和肝炎病毒，增加了提高对替代血源（如IAT）的认识和使用的必要性。
