Başaran Serdar Hakan, Bayrak Alkan, Sayit Emrah, Öneş Halil Nadir, Gözügöl Kadir, Kural Cemal
Department of Orthopaedics and Traumatology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul-Turkey.
Ulus Travma Acil Cerrahi Derg. 2019 Jan;25(1):66-70. doi: 10.5505/tjtes.2018.77823.
The aim of our study was to determine the efficacy and cost-effectiveness of intraoperative autotransfusion that uses the cell saver system (CSS) in patients undergoing posterior instrumentation and fusion of thoracic and lumbar vertebral fractures.
We divided 121 patients who were to undergo posterior instrumentation and fusion due to thoracic and lumbar vertebral fractures into two groups: 59 patients (23 males and 36 females) were in the cell saver group, and 62 patients (22 males and 40 females) were in the control group. Hemoglobin, hematocrit, and red blood cell (RBC) values were recorded for all patients preoperatively, on the postoperative first, second, and third days, and on the hospital discharge day. Transfusion rates and numbers of allogeneic erythrocyte transfusions, as well as the costs of transfused total auto- and allogeneic transfusions were compared.
The numbers of erythrocyte suspensions transfused perioperatively were 0.2±0.6 units in the cell saver group and 0.7±1.4 units in the control group (p=0.01). Statistically significant differences were noted between the two groups on the postoperative first, second, and third days in terms of hemoglobin, hematocrit, and RBC values. These differences had disappeared by the hospital discharge day. The average cost of perioperative blood transfusions was $431±27.4 in the cell saver group and $34.5±66.25 in the control group (p<0.001).
The use of the CSS was not cost-effective, but it was particularly successful at reducing the rate and the number of units of postoperative allogenic blood transfusions.
我们研究的目的是确定在胸腰椎骨折后路内固定融合手术中使用细胞回收系统（CSS）进行术中自体输血的有效性和成本效益。
我们将121例因胸腰椎骨折拟行后路内固定融合手术的患者分为两组：59例患者（23例男性和36例女性）为细胞回收组，62例患者（22例男性和40例女性）为对照组。记录所有患者术前、术后第1天、第2天、第3天及出院日的血红蛋白、血细胞比容和红细胞（RBC）值。比较输血率、异体红细胞输注数量以及自体和异体输血的总费用。
细胞回收组围手术期输注红细胞悬液的数量为0.2±0.6单位，对照组为0.7±1.4单位（p = 0.01）。两组在术后第1天、第2天和第3天的血红蛋白、血细胞比容和RBC值方面存在统计学显著差异。到出院日这些差异消失。细胞回收组围手术期输血的平均费用为431±27.4美元，对照组为34.5±66.25美元（p<0.001）。
使用CSS不具有成本效益，但在降低术后异体输血的发生率和单位数量方面特别成功。
