Homann B, Klaue P, Hauptvogel S
Anaesthesist. 1977 Nov;26(11):606.
In 12 vascular and 17 trauma cases the changes in the coagulation system due to intraoperative autotransfusion (IAT) were examined immediately after the IAT as well as 24, 48, 72 h and one week later. The following parameters were monitored: 1. Platelet count. --2. Prothrombin-time, partial-thromboplastin-time, factors II, V, VII, X and thrombin-clotting-time. --3. Fibrinogen, alpha-1-antitrypsin, alpha-2-macroglobulin, antithrombin III and plasminogen in 5 trauma cases. --4. Euglobulin-Lysis-Time. --After the IAT a loss of platelets, factors I, II, V, X, plasminogen and antithrombin III was found. Alpha-1-antitrypsin and alpha-2-macroglobulin remained unchanged or showed a slight increase. 24 h after treatment with Ugurol and heparin, fresh frozen plasma, fibrinogen and Cohn I-fraction in selected cases, an increasing normalisation of most parameters was seen, except for the plasma proteins active in coagulation. They showed a combination of "consumption coagulophathy" and "hyperfibrinolysis" up to the 7th day. Under treatment outlines above even marked laboratory changes remained without any clinical significance. Thus our results confirm that IAT does not cause any additional irreversible damage to the coagulation system. Therefore IAT can be considered as method of choice for the emergency treatment of massive bleeding.
在12例血管手术和17例创伤病例中，于术中自体输血（IAT）后即刻以及术后24、48、72小时和1周时，对凝血系统因IAT所发生的变化进行了检查。监测了以下参数：1.血小板计数。——2.凝血酶原时间、部分凝血活酶时间、因子II、V、VII、X以及凝血酶凝血时间。——3.在5例创伤病例中监测纤维蛋白原、α1抗胰蛋白酶、α2巨球蛋白、抗凝血酶III和纤溶酶原。——4.优球蛋白溶解时间。——IAT后发现血小板、因子I、II、V、X、纤溶酶原和抗凝血酶III有所减少。α1抗胰蛋白酶和α2巨球蛋白保持不变或略有增加。在选用乌古罗尔、肝素、新鲜冰冻血浆、纤维蛋白原和科恩I组分进行治疗24小时后，除参与凝血的血浆蛋白外，大多数参数逐渐恢复正常。直至第7天，它们呈现出“消耗性凝血病”和“纤维蛋白溶解亢进”的综合表现。在上述治疗方案下，即便实验室检查有明显变化，但并无任何临床意义。因此，我们的结果证实IAT不会对凝血系统造成任何额外的不可逆损害。所以，IAT可被视为大量出血紧急治疗的首选方法。
