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[术中自体输血(IAT)对创伤后腹腔内出血或血管手术中出血患者血浆蛋白的影响(作者译)]

[The influence of intraoperative autotransfusion (IAT) on plasmaproteins in patients with posttraumatic intraabdominal bleeding or hemorrhage during vascular surgery (author's transl)].

作者信息

Homann B, Kult J, Klaue P

出版信息

Prakt Anaesth. 1978 Dec;13(6):520-7.

PMID:740634
Abstract

In 29 patients (12 vascular and 17 trauma cases) the effect of intraabdominal bleeding and surgical management under intraoperative autotransfusion on several plasmaproteins was examined. The following parameters were monitored immediately before and after autotransfusion as well as 24, 48, 72 hours and one week later, in the thawed serum: 1. albumen and the carrier proteins prealbumen, transferrin, retinol-binding protein, 2. acute phase reactants: c-reactive protein coeruloplasmin, haptoglobin, 3. fractions of complement: C1q, C3c, C5 and C 3-activator, 4. serum-cholinesterase. With usual treatment by infusion of electrolyte solutions during operation and the following days, and further applicated blood transfusion, plasma and fresh frozen plasma by clinical needs, while the immediate blood loss during operation was replaced by autotransfusion, there was no change in preoperative dates. Only at the 3rd day the typical picture of catabolic situation of the postoperative period was observed in vascular cases and not at all in trauma cases. Thus the changes were closely related to the preexisting disease or state of shock, without further detoriation by intraoperative autotransfusion. 7 days later a sometimes overshooting normalization of the parameters was observed. Only cholinesterase remained extremely low, especially in vascular cases.

摘要

在29例患者(12例血管疾病和17例创伤病例)中,研究了腹腔内出血及术中自体输血的外科处理对几种血浆蛋白的影响。在自体输血前后以及解冻血清后的24小时、48小时、72小时和一周后,监测以下参数:1. 白蛋白及载体蛋白前白蛋白、转铁蛋白、视黄醇结合蛋白;2. 急性期反应物:C反应蛋白、铜蓝蛋白、触珠蛋白;3. 补体成分:C1q、C3c、C5和C3激活剂;4. 血清胆碱酯酶。术中及术后数天通过输注电解质溶液进行常规治疗,并根据临床需要进一步输注血液、血浆和新鲜冰冻血浆,术中即时失血通过自体输血补充,术前数据无变化。仅在第3天,血管疾病病例出现了术后分解代谢状态的典型表现,而创伤病例完全没有。因此,这些变化与原有疾病或休克状态密切相关,术中自体输血并未使其进一步恶化。7天后观察到参数有时会过度恢复正常。只有胆碱酯酶仍然极低,尤其是在血管疾病病例中。

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