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比较不同的血液保护技术在老年全髋关节置换术中的效果。

Comparison of the effects of different blood conservation techniques in elderly patients undergoing total hip arthroplasty.

机构信息

Department of Anesthesiology, Emergency General Hospital, Beijing, China.

出版信息

Afr Health Sci. 2023 Sep;23(3):514-520. doi: 10.4314/ahs.v23i3.59.

Abstract

BACKGROUND

To probe into the influences of different blood conservation techniques on the postoperative coagulation function and prognosis of elderly patients receiving Total Hip Arthroplasty (THA).

METHODOLOGY

A total of 60 patients were randomly divided into Autologous Blood Transfusion (ABT) group (n=30) and ANH group (n=30). For patients in the ABT group, an autologous blood recovery machine was used to recover, wash and filter the surgical field blood. For those in the Acute Isovolumic Hemodilution (ANH) group, blood was collected preoperatively from the central vein and stored in a citrate anticoagulant blood storage bag, while the same amount of hydroxyethyl starch was injected into the peripheral vein to dilute the blood. After Mai bleeding steps of the operation were completed, the autologous blood of patients was transfused back in both groups. The clinical indicators of patients in each group were observed.

RESULTS

48 h after operation, the ANH group obtained a higher level of hemoglobin (Hb), shorter Activated Partial Thromboplastin Time (APTT), and a lower expression rate of platelet activating factor CD62P than the ABT group.

CONCLUSION

The ANH group exhibits higher content of hemoglobin and fewer platelet (Plt)activating factors produced than the ABT group, while no significant difference in the shortened length of hospital stays is found.

摘要

背景

探讨不同的血液保护技术对接受全髋关节置换术(THA)的老年患者术后凝血功能和预后的影响。

方法

将 60 例患者随机分为自体输血(ABT)组(n=30)和急性等容血液稀释(ANH)组(n=30)。ABT 组采用自体血回收机回收、清洗、过滤手术野血液。ANH 组患者术前从中心静脉采集血液,储存在柠檬酸盐抗凝血储存袋中,同时外周静脉注入等容量羟乙基淀粉稀释血液。两组患者均在完成手术的Mai 出血步骤后,将患者的自体血回输。观察两组患者的临床指标。

结果

术后 48 h,ANH 组血红蛋白(Hb)水平较高,活化部分凝血活酶时间(APTT)较短,血小板活化因子 CD62P 表达率低于 ABT 组。

结论

与 ABT 组相比,ANH 组血红蛋白含量较高,血小板(Plt)激活因子产生较少,但住院时间缩短不明显。

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