Trubel W, Günen E, Wuppinger G, Tschernko E, Günen-Frank A, Staudacher M, Polterauer P
Department of Vascular Surgery, University of Vienna, Austria.
Thorac Cardiovasc Surg. 1995 Jun;43(3):165-70. doi: 10.1055/s-2007-1013792.
To regain blood shed intraoperatively, two different systems are clinically established: washing and centrifuging red blood cells to produce autologous erythrocyte concentrates and devices for immediate reinfusion of whole blood after mere filtration. In a prospective-randomised study to compare both methods regarding their efficiency, adverse effects, and economy, 20 patients of our department undergoing elective aortoiliac surgery received intraoperative autotransfusion by means of either cell-washing (CS) or salvage of whole blood (WB). Patients were preoperatively randomized into one of the two groups and were evaluated with respect to standard metabolic and haematological laboratory parameters preoperatively, during surgery, after transfer into the recovery room, 24 h after surgery, after transfer into the recovery room, 24 h after surgery, and at discharge. Both patient groups were well comparable in demographics, preoperative laboratory data, and indication for operation. Handling was easier, the set-up time was shorter with the whole blood filtration device (10.2 +/- 2.3 versus 21 +/- 1.9 min, p = 0.0023), and no additional personnel was needed to run the system. The whole blood device also allowed a greater percentage of aspirated blood to be returned intraoperatively compared to cell washing (73.5% +/- 7.2 versus 51.1% +/- 6.5, p = 0.03). Thrombocytopenia occurred in 7 (CS) and 3 (WB) patients intraoperatively with a significant difference in platelet count between the two groups (118 +/- 17 [CS] versus 170 +/- 12 [WB]*10(9)/L, p = 0.025). Expected changes in the perioperative course of the clotting parameters such as highly increased PTT levels and moderately prolonged prothrombin times occurred in all cases.(ABSTRACT TRUNCATED AT 250 WORDS)
为了补充术中失血，临床上建立了两种不同的系统：洗涤并离心红细胞以制备自体红细胞浓缩物，以及仅通过过滤后立即回输全血的装置。在一项前瞻性随机研究中，为比较这两种方法的效率、不良反应和经济性，我们科室20例行择期主-髂动脉手术的患者术中接受了自体输血，采用细胞洗涤法（CS）或全血回收法（WB）。患者术前随机分为两组之一，并在术前、术中、转入恢复室后、术后24小时、转入恢复室后、术后24小时以及出院时，就标准代谢和血液学实验室参数进行评估。两组患者在人口统计学、术前实验室数据和手术指征方面具有良好的可比性。全血过滤装置操作更简便，设置时间更短（10.2±2.3分钟对21±1.9分钟，p = 0.0023），且运行该系统无需额外人员。与细胞洗涤相比，全血装置还能使术中回输的吸出血液比例更高（73.5%±7.2对51.1%±6.5，p = 0.03）。术中7例（CS组）和3例（WB组）患者出现血小板减少，两组血小板计数有显著差异（118±17[CS组]对170±12[WB组]*10⁹/L，p = 0.025）。所有病例均出现凝血参数围手术期过程中的预期变化，如PTT水平大幅升高和凝血酶原时间适度延长。（摘要截断于250字）
