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[主动脉瘤手术中联合临时体外分流的术中自体输血]

[Intraoperative autotransfusion in aortic aneurysm operations combined with temporary external shunt].

作者信息

Akagawa H, Isamoto Y, Nakayama Y, Nakama T, Haraguchi S, Ohba H, Koga M

出版信息

Nihon Geka Gakkai Zasshi. 1987 Feb;88(2):199-204.

PMID:3574277
Abstract

Intraoperative autotransfusion was done in nine patients who underwent major vascular surgery for thoracic aortic aneurysms including one total abdominal aneurysm using temporal external shunt. After general heparinization (1mg/kg), shed blood was collected by Sorenson Autotransfusion System with local heparinization. After confirming ACT longer than 300-400 second, 425-3700 ml, averaged 1804 ml, of shed blood was reinfused to the patients by gravity flow. The reinfusion rate of shed blood was 43.1 +/- 15.8%. There were no deaths and no complications referable to autotransfusion. Although mild hemolysis was observed immediately after surgery, plasma free hemoglobin level returned to normal in the first operative day and no renal failure occurred. The volume of bleeding after surgery was not differed from that of control. Microembolism was not evident clinically. We concluded that intraoperative autotransfusion is safe and useful procedure in major vascular surgery if proper anticoagulation is done.

摘要

9例接受胸主动脉瘤大血管手术(包括1例使用临时体外分流的全腹主动脉瘤手术)的患者进行了术中自体输血。全身肝素化(1mg/kg)后,用Sorenson自体输血系统收集失血并进行局部肝素化。确认活化凝血时间(ACT)超过300 - 400秒后,将425 - 3700毫升(平均1804毫升)失血通过重力流回输给患者。失血回输率为43.1 +/- 15.8%。无因自体输血导致的死亡和并发症。虽然术后立即观察到轻度溶血,但血浆游离血红蛋白水平在术后第一天恢复正常,且未发生肾衰竭。术后出血量与对照组无差异。临床上未发现明显的微栓塞。我们得出结论,如果进行适当的抗凝,术中自体输血在大血管手术中是一种安全且有用的方法。

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