Tulloh B R, Brakespear C P, Bates S C, Adams D C, Dalton R G, Richards M J, Durkin M A, Bristol J B, Poskitt K R
Department of Surgery, Cheltenham General Hospital, Gloucestershire, UK.
Br J Surg. 1993 Mar;80(3):313-5. doi: 10.1002/bjs.1800800314.
The feasibility of predonated autologous blood transfusion and intraoperative blood salvage in elective abdominal aortic aneurysm repair was studied. Twenty consecutive patients were evaluated, of whom five were excluded according to protocol criteria. Patients each donated 1 unit blood 14 and 7 days before operation. A third unit was withdrawn in the anaesthetic room and replaced with Hartmann's solution, producing a haemodiluted state. Intraoperative losses were minimized using the Haemonetics Cell Saver III Plus autotransfusion system. Predonated blood from two patients passed its expiry date owing to repeated operation postponements, leaving 13 patients for study. The mean(s.d.) intraoperative blood loss was 700(300) ml with a mean(s.d.) intraoperative salvage of 420(300) ml. Two patients were transfused intraoperative salvage of 420(300) ml. Two patients were transfused according to clinical need. Thus nine patients safely avoided homologous transfusion. With autologous predonation, haemodilution and intraoperative blood salvage, elective aortic aneurysm repair can be performed safely with minimal need for homologous blood.
研究了择期腹主动脉瘤修复术中预存自体输血和术中血液回收的可行性。对连续20例患者进行了评估，其中5例根据方案标准被排除。患者在手术前14天和7天各捐献1单位血液。在麻醉室抽取第三单位血液，并用哈特曼氏溶液替代，形成血液稀释状态。使用Haemonetics Cell Saver III Plus自体输血系统将术中失血降至最低。由于多次手术推迟，两名患者的预存血液过期，剩余13例患者用于研究。术中平均（标准差）失血量为700（300）ml，术中平均（标准差）回收血量为420（300）ml。两名患者根据临床需要接受了输血。因此，9名患者安全地避免了异体输血。通过自体预存、血液稀释和术中血液回收，择期主动脉瘤修复术可以安全进行，对异体血的需求降至最低。
