Blevins F T, Shaw B, Valeri C R, Kasser J, Hall J
Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
J Bone Joint Surg Am. 1993 Mar;75(3):363-71. doi: 10.2106/00004623-199303000-00007.
A prospective study was done of the results of infusion of drained blood after major procedures on the spine and hip in twenty-six patients. The Solcotrans system was used to salvage drained blood in the first six hours after the operation. Transfusion requirements, blood loss, hematocrit, temperature, prothrombin time, partial prothrombin time, platelet count, results of blood cultures, and levels of factor VIII, factor V,D-dimer, antithrombin III, plasminogen, protein C, and complement C3a des arginine were determined for some or all of the patients. A mean of 375 milliliters of blood from the Solcotrans receptacle was reinfused. All of the cultures were negative. There were no febrile reactions. The mean values for the specimens of the salvaged blood were: hematocrit, 0.20; hemoglobin, seventy-one grams per liter; plasma hemoglobin, 2.36 grams per liter; C3a des arginine, 9.4 x 10(-3) grams per liter; fat particles of less than nine micrometers in diameter, 23,643 per milliliter; and D-dimer, 205 x 10(-3) grams per liter. Studies of blood samples that were collected from patients one to two hours and twelve to eighteen hours after the transfusion showed only slight increases in fibrin split products one hour after the transfusion; these values reverted to normal by eighteen hours. No clinical coagulopathy associated with reinfusion was observed. The reinfusion of unwashed, filtered shed blood that was as much as 15 per cent of the total blood volume proved to be a safe technique after major orthopaedic procedures.
对26例接受脊柱和髋关节大手术的患者进行了一项前瞻性研究，观察术后引流血回输的效果。使用Solcotrans系统在术后头6小时内收集引流血。测定了部分或全部患者的输血需求、失血量、血细胞比容、体温、凝血酶原时间、部分凝血活酶时间、血小板计数、血培养结果以及因子VIII、因子V、D-二聚体、抗凝血酶III、纤溶酶原、蛋白C和补体C3a去精氨酸的水平。平均回输了来自Solcotrans容器的375毫升血液。所有血培养均为阴性。未出现发热反应。回输血标本的平均值为：血细胞比容0.20；血红蛋白71克/升；血浆血红蛋白2.36克/升；C3a去精氨酸9.4×10⁻³克/升；直径小于9微米的脂肪颗粒23,643个/毫升；D-二聚体205×10⁻³克/升。对输血后1至2小时和12至18小时采集的患者血样进行研究发现，输血后1小时纤维蛋白降解产物仅略有增加，18小时时这些值恢复正常。未观察到与回输相关的临床凝血障碍。在骨科大手术后，回输未洗涤、过滤的引流血，其量高达总血容量的15%，被证明是一种安全的技术。
