Yokoyama S, Kawahara T, Moriyama K, Kadota K, Asakura T, Shinmyozu K
Department of Neurosurgery, Faculty of Medicine, Kagoshima University.
No Shinkei Geka. 1994 Jul;22(7):627-30.
Homologous transfusion has been known to cause viral infections and other complications. Recently, autologous transfusion has been adopted widely as a safer and more effective procedure to prevent these complications. The authors report the experiences of 29 patients who had been operated on after preparation of autologous blood. Furthermore, the authors report a study concerning maximum surgical blood order schedule (MSBOS) of these operations. 212 patients operated on between January, 1991 and June, 1993 were used for this study of MSBOS. Although intraoperative transfusion was performed on 14 of 29 patients, the need for homologous transfusion was avoided in 12 of these 14 patients by the use of autologous blood. The frequency of homologous transfusion was reduced significantly after the introduction of pre-operative autologous blood collection in our clinic. The patients' value of hemoglobin fell after the collection of blood but these levels were not so seriously low as to impede the performance of operations. 212 cases of operated patients were divided according to the operative methods and diagnosis for calculation of MSBOS. The results were as follows; Craniotomy and removal of glioma 5u, meningioma 11u, neurinoma 7u, AVM 5u, transsphenoidal surgery 3u, Moyamoya disease 2u and V-P or S-P shunt 0u. Pre-operative autologous blood collection is easy to achieve for scheduled neurosurgical operations, and autologous transfusion is a beneficial procedure which should be used more widely.
已知同种异体输血会导致病毒感染及其他并发症。近来，自体输血作为一种更安全、有效的预防这些并发症的方法已被广泛采用。作者报告了29例自体血制备后接受手术患者的经验。此外，作者还报告了一项关于这些手术的最大外科用血计划（MSBOS）的研究。本研究选取了1991年1月至1993年6月间接受手术的212例患者进行MSBOS研究。虽然29例患者中有14例术中进行了输血，但其中12例通过使用自体血避免了同种异体输血的需求。在我们诊所引入术前自体血采集后，同种异体输血的频率显著降低。采血后患者的血红蛋白值有所下降，但这些水平并未低到妨碍手术进行的程度。将212例手术患者根据手术方式和诊断进行分组，以计算MSBOS。结果如下：开颅胶质瘤切除术5单位，脑膜瘤切除术11单位，神经鞘瘤切除术7单位，动静脉畸形切除术5单位，经蝶窦手术3单位，烟雾病手术2单位，脑室-腹腔或脑室-心房分流术0单位。对于预定的神经外科手术，术前自体血采集易于实现，自体输血是一种有益的方法，应更广泛地应用。
