全髋关节置换术中自体血回输对患者炎性细胞因子的影响

发布时间：2018-03-16 00:32

本文选题：全髋关节置换术　切入点：自体血回输　出处：《中国输血杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的探讨全髋关节置换术中自体血回输对患者炎性细胞因子的影响。方法以2012年1月-2015年6月我院行术中自体血回输的84例全髋关节置换患者为自体血回输组,采用Cell Saver5型自体血液回输机进行术中自体血回输。以同期单纯输注异体血的全髋关节置换患者76例为对照组。于麻醉诱导前、术后24 h和术后7 d用肝素抗凝试管采集空腹静脉血,采用ELISA法检测白介素-6、干扰素-γ、肿瘤坏死因子-α。对2组患者的年龄、性别比、体质量、术前Hb、术前Hct等一般资料进行统计。记录2组术中失血量、术中回收血量、异体血输入量、输血不良反应及术后感染情况。结果 12组患者在平均年龄、性别比、体质量及术前Hb、术前Hct等方面差异无统计学意义(P0.05);22组患者术中失血量无统计学差异(P0.05)。自体血回输组异体血输入量、输血不良反应和术后感染发生率低于对照组,差异比较有统计学意义(P0.05);32组患者术后24 h和术后d7白介素-6与术前相比明显升高(P0.05),自体血回输组升高幅度高于对照组(P0.05);自体血回输组术后d7干扰素-γ明显升高,而对照组干扰素-γ术后24 h下降,术后d7恢复至术前水平;与术前相比,两组术前术后TNF-α均无明显变化。结论全髋关节置换术中自体血回输可显著提高患者术后白介素-6、干扰素-γ的水平,对输血安全和临床治疗具有重要意义。
[Abstract]:Objective to investigate the effect of autologous blood transfusion on inflammatory cytokines in total hip arthroplasty. Methods 84 patients with total hip replacement underwent autologous blood transfusion from January 2012 to June 2015 in our hospital. Autologous blood transfusion was performed with Cell Saver5 autogenous blood transfusion machine during operation. 76 cases of total hip replacement patients who received allogeneic blood transfusion at the same time were taken as control group. Fasting venous blood was collected with heparin anticoagulant test tube 24 hours after operation and 7 days after operation. Interleukin-6, interferon- 纬 and tumor necrosis factor- 伪 were detected by ELISA method. The general data of preoperative HB and preoperative Hct were recorded. The blood loss, the volume of blood recovered during operation, the volume of allogeneic blood, the adverse reaction of blood transfusion and the infection after operation were recorded in both groups. Results the average age and sex ratio of the 12 groups were compared. There was no significant difference in body mass, preoperative HB and preoperative Hct. There was no significant difference in blood loss during operation in group P0.05. The volume of allogeneic blood, the adverse reaction of transfusion and the incidence of postoperative infection in autogenous blood transfusion group were lower than those in control group. The difference was statistically significant (P 0.05). The levels of Interleukin-6 and interferon-纬 in the autogenous blood transfusion group were significantly higher than those in the control group at 24 hours after operation and on the 7th day after operation compared with those before operation, and the levels of interferon-纬 in the autologous blood transfusion group were significantly higher than those in the control group. In the control group, interferon-纬 decreased 24 hours after operation and recovered to the preoperative level on the 7th day after operation. Conclusion Autologous blood transfusion in total hip arthroplasty can significantly increase the levels of interleukin-6 and interferon- 纬 in patients with total hip arthroplasty, which is of great significance to the safety of blood transfusion and clinical treatment.
【作者单位】：河北省中医院检验科;
【分类号】：R457.1;R687.4

【相似文献】