术中自体回收洗涤红细胞携氧能力评价

发布时间：2018-01-01 16:23

本文关键词：术中自体回收洗涤红细胞携氧能力评价　出处：《中国输血杂志》2016年03期 　论文类型：期刊论文

【摘要】：目的评价术中自体回收红细胞的携氧释氧能力。方法共20名年龄18-70岁择期行非停跳冠脉搭桥手术、使用术中血液回收的患者入组本研究。拟合患者开始进行血液洗涤时的静脉血、回收洗涤和贮存悬浮红细胞的氧合血红蛋白解离曲线(OHDC),同时测定红细胞2,3-二磷酸甘油酸(2,3-DPG)含量。OHDC的测定采用标准混合法,2,3-DPG含量测定采用比色法。对比静脉血、自体回收血和贮存悬浮红细胞OHDC的形状、位置、P50值,和2,3-DPG含量。结果血氧饱和度在20%-80%范围内的自体回收红细胞OHDC方程式为Log[SO_2/(1-SO_2)]=-4.1+2.8 Log PO_2(R~2=0.997,P0.01),静脉血红细胞OHDC方程式为Log[SO_2/(1-SO_2)]=-3.8+2.7 Log PO_2(R~2=0.998,P0.01),贮存悬浮红细胞OHDC方程式为Log[SO_2/(1-SO_2)]=-2.8+2.4 Log PO_2(R~2=0.973,P0.01)。回收血红细胞的OHDC较静脉血的OHDC右移,贮存悬浮红细胞的OHDC较静脉血的OHDC左移。回收洗涤红细胞的P50值(28.1±0.4)mm Hg,较静脉血红细胞(26.4±0.2mm)Hg升高(P0.01),贮存悬浮红细胞P50值(15.8±0.6)mm Hg,明显低于静脉血和回收洗涤红细胞P50值(P0.01)。回收洗涤红细胞的2,3-DPG含量(6.14±2.40)μmol/g Hb,明显高于静脉血(4.92±2.05)μmol/g Hb(P0.01);贮存悬浮红细胞的2,3-DPG含量(0.78±0.33)μmol/g Hb,较静脉血和回收洗涤血液明显降低(P0.01)。结论术中自体回收红细胞保持了同静脉血红细胞相似的携氧释氧功能。贮存10-15 d的悬浮红细胞携氧释氧功能明显降低。
[Abstract]:Objective to evaluate the intraoperative recovery of oxygen carrying red blood cell oxygen releasing ability. Methods a total of 20 subjects aged 18-70 years undergoing off-pump coronary artery bypass surgery, the use of intraoperative blood salvage in patients enrolled in this study. The venous blood in patients with fitting started on blood washing, washing and recycling of suspended red blood cell oxygen storage hemoglobin dissociation curve (OHDC), simultaneous determination of red blood cell 2,3- - (2,3-DPG).OHDC content was measured by Standard mixing method, the colorimetric method for the determination of 2,3-DPG. Comparison of venous blood, autologous blood recovery and storage of suspended red blood cells OHDC shape, position, P50 value, and the content of 2,3-DPG. The results of autologous blood oxygen saturation at 20%-80% within the scope of the recovery of red blood cell OHDC equation is Log[SO_2/ (1-SO_2)]=-4.1+2.8 Log PO_2 (R~2=0.997, P0.01), blood red cell OHDC equation is Log[SO_2/ (1-SO_2)]=-3.8+ Log PO_2 (R~2=0.998, P0 2.7 .01), storage of suspended red blood cells OHDC equation Log[SO_2/ (1-SO_2)]=-2.8+2.4 Log PO_2 (R~2=0.973, P0.01). The recovery of red blood cells with OHDC venous blood OHDC right, storage of red cells suspension OHDC venous blood left OHDC. The recovery of washed red blood cells P50 value (28.1 + 0.4) mm Hg a red blood cell, vein (26.4 + 0.2mm) increased Hg (P0.01), storage of suspended red blood cells P50 value (15.8 + 0.6) mm Hg was significantly lower than that of venous blood and recovery of washed red blood cells P50 value (P0.01). The content of 2,3-DPG and recovery of washed red blood cells (6.14 + 2.40) mol/g Hb was significantly higher than that of venous blood (4.92 + 2.05) mol/g Hb (P0.01); the 2,3-DPG content of stored red cells suspension (0.78 + 0.33) mol/g Hb was significantly lower than that of venous blood and blood washing recovery (P0.01). Conclusion intraoperative autologous RBC recovery maintained the same vein red blood cells was similar to that of the oxygen carrying oxygen release function storage of suspended red blood cells D 10-15 The function of oxygen - carrying oxygen release was obviously reduced.

【作者单位】：首都医科大学附属北京友谊医院麻醉科;首都医科大学附属北京安贞医院;
【基金】：北京自然科学基金(7122050) 首都卫生发展科研专项(首发2011-2002-06) 首都医科大学附属北京友谊医院科研启动资金(yyqdkt2011-25)
【分类号】：R457.1
【正文快照】： 术中自体血液回收技术在临床上已经应用多年,其减少异体红细胞输注的作用已经明确[1]。血液回收过程中,血液回收机对术野失血的全程处理,包括负压吸引收集、抗凝、过滤、离心及清洗会对红细胞造成物理和化学损伤[2],同时凝血因子、炎症介质、组织碎片、血小板和白细胞等也被激

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