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[Solcotrans plus用于腹主动脉瘤切除术中自体血的术中抽吸与回输]

[Intraoperative aspiration and reinfusion of autologous blood in resection of abdominal aortic aneurysms with Solcotrans plus].

作者信息

Walpoth B, Schmid R, Amport T, Rothen H U, Spaeth P, Kurt G, Stirnemann P, Nachbur B, Althaus U

机构信息

Universitätsklinik für Thorax-, Herz- und Gefässchirurgie, Inselspital Bern.

出版信息

Helv Chir Acta. 1993 Jun;59(5-6):843-8.

PMID:8376151
Abstract

Quantitative and qualitative assessment of intraoperative aspiration and reinfusion of autologous blood with the Solcotrans was carried out in 11 males (52-79 years) undergoing elective resection of abdominal aortic aneurysms. Hematology, blood chemistry, coagulation parameters and complement activation were studied in the patient's blood at the following time points: preoperatively, before and after heparinisation, after retransfusion of the first and last Solcotrans, 6 and 20 hours postoperatively. In addition the same quality control was performed in the first and last Solcotrans blood. Results (mean values of 11 patients +/- 1 SD): Intraoperatively 2-3 Solcotrans units were salvaged (total 1039 +/- 565 ml) of which 805 +/- 487 ml were retransfused to the patients. As a mean patients required only 1 unit of homologous RBC's (395 +/- 781 ml) intraoperatively. Patient's intraoperative hemoglobin concentration amounted to 10 g/dl or more. Whereas the hemoglobin level in the Solcotrans attained only 8.2 g/dl. Thrombocyte counts (48 +/- 18 x 10(9)/l) and ionized calcium (0.2 +/- 0.4 mmol/l) were significantly depressed when compared to the preoperative patient values (p < 0.05). The protein concentration remained within normal limits in the patient's and in the Solcotrans blood. Complement activation (C4a, C5a [des Arg]) showed a significant increase after initiation of surgery and there was no significant difference between the solco- or patient blood. Whereas plasma free hemoglobin, coagulation and fibrinolysis parameters showed a significant elevation in the Solcotrans blood. In conclusion the solcotrans system offers a fast, efficient and simple method for salvage and retransfusion of intraoperative autologous blood.

摘要

对11例(年龄52 - 79岁)接受择期腹主动脉瘤切除术的男性患者,使用索科输血器(Solcotrans)对术中自体血进行了抽吸和回输的定量及定性评估。在以下时间点研究了患者血液中的血液学、血液化学、凝血参数和补体激活情况:术前、肝素化前后、首次和末次索科输血器回输后、术后6小时和20小时。此外,对首次和末次索科输血器中的血液进行了同样的质量控制。结果(11例患者的平均值±1标准差):术中回收到2 - 3个索科输血器单位的血液(总量1039±565毫升),其中805±487毫升回输给了患者。平均而言,患者术中仅需要1单位的异体红细胞(395±781毫升)。患者术中血红蛋白浓度达到10克/分升或更高。而索科输血器中的血红蛋白水平仅为8.2克/分升。与术前患者值相比,血小板计数(48±18×10⁹/升)和离子钙(0.2±0.4毫摩尔/升)显著降低(p < 0.05)。患者血液和索科输血器血液中的蛋白质浓度保持在正常范围内。补体激活(C4a、C5a[去精氨酸])在手术开始后显著增加,索科输血器血液和患者血液之间无显著差异。而血浆游离血红蛋白、凝血和纤维蛋白溶解参数在索科输血器血液中显著升高。总之,索科输血器系统为术中自体血的回收和回输提供了一种快速、高效且简单的方法。

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