Kurisu K, Yonenaga K, Miyamoto K, Furusho N, Nishimura K
Department of Cardiovascular Surgery, Kumamoto City Hospital, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Jun;46(6):544-8. doi: 10.1007/BF03250597.
In 22 consecutive patients with tetralogy of Fallot (TF), a total correction was attempted without the use of a homologous blood transfusion from September 1995 to March 1997. The 22 patients were divided into two groups according to their surgical procedures; namely, either a simple correction (group I: n = 14) or a complex correction including the relief of peripheral pulmonary stenosis and/or the division of a previous systemic-pulmonary shunt (group II: n = 8). In 77% of all patients, surgery was performed without a homologous blood transfusion. No differences were found in the non-transfusion rate and the hematocrit (Ht) values between the two groups and, as a result, we thus confirm that this additional procedure is not a risk factor for surgery without a homologous blood transfusion. According to the correlation of the red blood cell volume before and after surgery, the preoperative Ht value corresponding to the postoperative Ht of 30% could be accurately predicted. The calculated Ht values were 41.0% in the patient weighing 15 kg, 42.5% in those weighing 10 kg, and 46.9% in those weighing 5 kg. These data suggest that a surgical correction without a homologous blood transfusion can therefore be safely performed in almost all patients with TF.
1995年9月至1997年3月期间，对22例法洛四联症（TF）患者尝试在不使用同种异体输血的情况下进行根治手术。根据手术方式将22例患者分为两组；即单纯矫正组（I组：n = 14）或包括解除外周肺动脉狭窄和/或切断既往体肺分流的复杂矫正组（II组：n = 8）。77%的患者手术时未进行同种异体输血。两组之间的非输血率和血细胞比容（Ht）值无差异，因此，我们证实该附加手术不是不进行同种异体输血手术的危险因素。根据手术前后红细胞体积的相关性，可以准确预测术后Ht为30%时对应的术前Ht值。体重15 kg患者的计算Ht值为41.0%，体重10 kg患者为42.5%，体重5 kg患者为46.9%。这些数据表明，几乎所有TF患者都可以安全地进行不进行同种异体输血的手术矫正。
