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老年患者非同源输血的心脏直视手术

[Open heart surgery without homologous blood transfusion in elderly patients].

作者信息

Kanno S, Akimoto H, Nagamine S, Arai S, Sato S, Tabayashi K

机构信息

Department of Cardiac Surgery, Tohoku Kousai Hospital, Sendai, Japan.

出版信息

Kyobu Geka. 1997 Jul;50(8 Suppl):702-6.

PMID:9251498
Abstract

Preoperative autologous blood donation has been widely accepted to perform surgery in orthopedics, gynecology and cardiac surgery. In elderly patients, however, it has been supposed that most of these patients have anemic tendency before predonation as well as poor response to erythropoietic stimuli, so that preoperative blood deposit is limited to apply them. In order to reduce homologous blood transfusion in open-heart surgery, preoperative blood deposit, combined with erythropoietin administration and intraoperative blood salvage, have been routinely used even for the elderly patients in our hospital since 1989. In present study, we verified above concepts and obtained the results that demonstrated little differences in the blood reproducing ability, the rate of predonation, and the recovery after the operation, between the elderly and the younger. We concluded that autologous blood transfusion combining preoperative deposit with intraoperative blood salvage was the efficient and safe method even in the elderly patients.

摘要

术前自体血捐献已被广泛应用于骨科、妇科和心脏外科手术中。然而,对于老年患者,人们认为大多数患者在献血前就有贫血倾向,并且对促红细胞生成刺激的反应较差,因此术前储血在应用于他们时受到限制。为了减少心脏直视手术中的异体输血,自1989年以来,我院常规使用术前储血,并结合促红细胞生成素给药和术中血液回收,即使是老年患者也如此。在本研究中,我们验证了上述概念,并得出结果表明,老年患者和年轻患者在血液再生能力、献血率和术后恢复方面几乎没有差异。我们得出结论,术前储血与术中血液回收相结合的自体输血即使对老年患者也是有效且安全的方法。

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