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《术中自体血回输在脊柱快速康复外科手术中的应用.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、734JBengbuMedCoil,June2015,Vol40,No.6[文章编号]1000-2200(2015)06-0734-04·临床医学·术中自体血回输在脊柱快速康复外科手术中的应用周玲。谢言虎,秦红。柴小青[摘要]目的:观察术中自体血回输技术对脊柱外科患者炎性反应、凝血功能及其他并发症的影响。方法:选择择期预计出血量超过600ml,全麻下拟行脊柱手术的患者60例,采用随机数字表法均分为自体血液回输组(A组)和异体输血组(B组)。记录2组患者自体或异体输血前、输血后1h(T2)、24h(T)、48h(T4)、72h(T5)动脉血气
2、分析和凝血功能,并采用放射免疫法测定白细胞介素(IL)-6和IL一10。观察术后感染、切口愈合情况和住院时间。结果:A组自体血液回输后T:~T5时点IL-6水平均明显低于B组(P<0.01),而IL.10均低于B组(P<0.01);2组输血后不同时点血红蛋白和凝血功能差异均无统计学意义(P>0.05)。A组患者术后无任何相关输血并发症的发生,切口愈合良好,手术后住院时间较B组明显缩短(P<0.01)。结论:脊柱手术中使用自体血回输技术,可明显减轻IL-6和IL一10等炎症因子水平的改变,减少患者手术后并发症,达到快速康复的目的。[关键词]自
3、体血液回输;脊柱/外科手术;快速康复[中图法分类号]R457.1[文献标志码]ADOI:10.13898/j.cnki.issn.1000—2200.2015.06.011ApplicationoftheintraoperativeautotransfusioninspinalrapidrehabilitationsurgeryZHOULing,XIEYan-hu,QINHong,CHAIXiao-qing(DepartmentofAnesthesiololgy,AnhuiProvincalHospitalAfiliatedtoAnhuiM
4、edicalUniversity,HefeiAnhui230001,China)[Abstract]0bjecfive:Toobservetheeffectsofintraoperativeautotransfusionontheinflammatoryreaction,coagulationfunctionandothercomplicationsofspinesurgerypatients.Methods:Sixtyspinesurgerypatients,whosehaemorrhageamountwasexpectedtomoret
5、han600ml,wererandomlydividedintotheautotransfusiongroup(groupA)andallogeneictransfusiongroup(groupB)usingarandomnumbertable(30casesineachgroup).Arterialbloodgasanalysis,coagulationfunctionandthelevelsofinterleukin-6and一10(IL-6and—lo)detectedbyradioimmunoassayintwogroupswer
6、erecordedbeforetransfusion,after1h(T2),24h(T3),48h(T4)and72h(T5)oftransfusion.Thepostoperativeinfection,woundhealingandhospitalizationdaysintwogroupswereobservedafteroperation.Results:ThelevelsofIL-6andIL一10ingroupAatT2toT5weresignificantlylowerthanthoseingroupB(P<0.O1).Th
7、ediferencesofHemoglobinandcoagulationfunctionaftertransfusionbetweentwogroupswerenotstatisticallysignificant(P>0.05).ComparedwithgroupB,n0postoperativetransfusioncomplication,goodwoundhealingandshorthospitalizationdayswerefoundingroupA(P<0.01).Conclusions:Theintraoperative
8、autotransfusioncanobviouslyreducethelevelsofIL-6andIL一10andpostoperativecomplication,andp
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