自体血回输对体外循环心脏瓣膜置换患者凝血功能及血氧代谢的影响

发布时间：2018-10-20 10:34

【摘要】：目的探讨自体血回输对体外循环(ECC)心瓣膜置换术患者凝血功能及血氧代谢的影响。方法选择本院术中实施自体血回输的ECC心脏瓣膜置换患者为研究对象,检测术前、术毕、术后24 h及术后7 d凝血功能及血氧代谢指标。采用ADVIA2120血液分析仪检测EDTA抗凝血血小板(Plt)、红细胞(RBC)、血红蛋白(Hb)、红细胞压积(Hct);采用CA530全自动血凝分析仪及D-二聚体检测试剂盒测定枸橼酸钠抗凝血凝血酶原时间(PT)、凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)及D-二聚体;采用ABL800血气分析仪测定动脉血酸碱度(p H)、氧分压(PaO_2)、血氧饱和度(SaO_2);记录患者自体血回输过程中不良反应、红细胞输注量及预后情况。结果1)68名患者平均回输浓缩红细胞(516±239)m L。2)与术前比较,术毕及术后24 h Plt、FIB分别为明显下降(P0.01);而PT明显延长(P0.05);术毕D-D有所升高(P0.05)。术毕及术后24 h PaO_2明显升高(P0.01);术毕及术后24 h RBC、Hb和Hct均有一定程度下降(P0.05)。结论洗涤式自体血回输技术能及时回收术中失血,对ECC心瓣膜置换术患者凝血功能及携氧能力影响较小,可有效维持血液循环,有利于患者术后恢复。
[Abstract]:Objective to investigate the effect of autologous blood transfusion on coagulation function and blood oxygen metabolism in patients undergoing cardiopulmonary bypass (ECC) cardiac valve replacement. Methods ECC heart valve replacement patients who underwent autologous blood transfusion during operation were selected as study subjects. The coagulation function and blood oxygen metabolism were measured before, 24 hours, 24 hours and 7 days after operation. Detection of EDTA Anticoagulant Platelet by ADVIA2120 Blood Analyzer (Plt), erythrocyte (RBC), hemoglobin (Hb), hematocrit (Hct); using CA530 automatic Hemagglutination Analyzer and Ddimer Detection Kit to detect Sodium Citrate Antithrombin time (PT), Thrombin time (APTT), thrombin time (TT), fibrinogen (FIB) and D-dimer; (p H), partial pressure of oxygen (PaO_2) and blood oxygen saturation (SaO_2) were measured by ABL800 blood gas analyzer, and adverse reactions, erythrocyte infusion volume and prognosis were recorded during autologous blood transfusion. Results 1) compared with pre-operation, the Plt,FIB of 68 patients was significantly decreased after operation and 24 hours after operation (P0.01), but PT was prolonged (P0.05), D-D was increased after operation (P0.05). PaO_2 increased significantly at the end of operation and 24 hours after operation (P0.01), RBC,Hb and Hct decreased to a certain extent after operation and 24 hours after operation (P0.05). Conclusion washing autologous blood transfusion technique can recover blood loss in time and has little effect on coagulation function and oxygen carrying capacity of ECC heart valve replacement patients. It can effectively maintain blood circulation and is beneficial to postoperative recovery.
【作者单位】：河北省中医院检验科;
【分类号】：R654.2;R457.1

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