国产3000P型自体血回收机在脊柱手术中血液回收质量的评价

发布时间：2018-02-14 01:20

本文关键词： 自体血回收机脊柱手术红细胞形态 2 3-DPG 肝素游离血红蛋白　出处：《中南大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的：评价脊柱手术中血液回收的质量,对比观察国产京精3000P型和进口Haemonetics Cell Saver5+型自体血回收机在脊柱手术中回收血液的质量。方法：选择择期行脊柱手术的患者40例,随机分为两组,CS5+组和3000P组,每组20例。分别使用相应的进口Haemonetics Cell Saver5+型和国产京精3000P型自体血回收机进行洗涤式血液回收。观察两组洗涤前、后血红细胞的形态,比较红细胞畸形率；用分光光度法测定红细胞中2,3-DPG的含量,评估红细胞的携氧功能；测定血常规、血气、游离血红蛋白和肝素的含量；并与术前动脉血和CPDA-1保养液保存三周以上的库存血比较。结果：1、与术前动脉血相比,两组洗涤前、后血红细胞畸形率较高(p0.01),但两组洗涤后血红细胞畸形率较洗涤前血明显降低(p0.01),且明显低于库存血红细胞畸形率(p0.01)。两组间红细胞畸形率无明显差异(p0.05)。 2、两组洗涤后血红细胞中2,3-DPG含量较洗涤前血降低(p0.01),但与术前动脉血相比无明显差异(p0.05),且明显高于库存血红细胞中2,3-DPG含量(p0.01)。两组间红细胞中2,3-DPG含量无明显差异(p0.05)。 3、CS5+组和3000P组洗涤后血的Hct分别为38.9%±7.5%和34.7%±9.7%；Hb分别为129.2±27.3g/l和114.8±27.4g/l；游离血红蛋白含量分别为1.048±0.507g/l和1.147±0.432g/l；残余肝素含量分别为0.014±0.013IU/ml和0.016±0.011IU/ml; K+分别为4.51±0.24mmol/l和4.67±0.32mmol/l。 4、CS5+组和3000P组的红细胞回收率分别为77.14%±13.97%和74.62%±9.71%；游离血红蛋白的清除率分别为95.46%±1.81%和95.53%±1.85%；肝素的清除率分别为99.77%±0.14%和99.62%±0.19%；K+的清除率分别为84.49%±4.27%和84.69%±6.25%。两组间红细胞回收率和各物质清除率均没有统计学差异(p0.05)。结论：1、两种自体血回收机在回收和清洗过程中对红细胞的形态均有一定的影响,但洗涤后得到的红细胞形态较好,且优于库存血。 2、经两种白体血回收机清洗后血的红细胞中2,3-DPG含量均有所降低,但与术前动脉血一样具备良好的携氧功能,且优于库存血。 3、脊柱手术中两种自体血回收机均能得到较好质量的浓缩红细胞,对FHb、肝素、K+离子等清除完全,符合临床标准。 4、国产京精3000P型和Haemonetics Cell Saver5+型自体血回收机在脊柱手术中血液回收的质量以及处理血液的效果相近。
[Abstract]:Objective: to evaluate the quality of blood recovery in spinal surgery, and to observe the quality of autogenous blood recovery in spinal surgery by domestic Jingjing 3000P type and imported Haemonetics Cell Saver5 type autologous blood recovery machine. Methods: forty patients undergoing spinal surgery were randomly divided into two groups: CS5 group and 3000P group. 20 patients in each group were treated with Haemonetics Cell Saver5 and Jingjing 3000P autologous blood recovery machine respectively. The morphology of red blood cells before and after washing was observed and the deformity rate of red blood cells was compared between the two groups. The contents of 2n3-DPG in erythrocytes were determined by spectrophotometry to evaluate the oxygen-carrying function of erythrocytes, the contents of blood routine, blood gas, free hemoglobin and heparin were measured, and the results were compared with those stored in arterial blood and CPDA-1 maintenance solution for more than three weeks before operation. Results compared with preoperative arterial blood, the two groups, before washing, The deformity rate of hind blood red blood cell was higher than that before washing, but the deformity rate of red blood cell after washing in the two groups was significantly lower than that before washing, and was significantly lower than that in the stock. There was no significant difference between the two groups in the deformity rate of red blood cell (P 0.05). (2) after washing, the content of 2o 3-DPG in red blood cells of the two groups was lower than that before washing, but there was no significant difference between the two groups compared with the arterial blood before washing, and the content of 2F3 DPG was significantly higher than that of the stored red blood cells (P 0.01). There was no significant difference between the two groups in the contents of 2o 3-DPG in red blood cells (P 0.05). 3The Hct of washed blood in CS5 group and 3000P group was 38.9% 卤7.5% and 34.7% 卤9.7 g / L, respectively, the HB was 129.2 卤27.3 g / l and 114.8 卤27.4 g / l, the content of free hemoglobin was 1.048 卤0.507 g / l and 1.147 卤0.432 g / l, the residual heparin content was 0.014 卤0.013 渭 mol / ml and 0.016 卤0.011 mol / ml, K was 4.51 卤0.24 mmol / ml and 4.67 卤0.32 mmol / L, respectively. 4 the erythrocyte recovery rates of CS5 group and 3000P group were 77.14% 卤13.97% and 74.62% 卤9.71, the clearance rates of free hemoglobin were 95.46% 卤1.81% and 95.53% 卤1.85, the clearance rates of heparin were 99.77% 卤0.14% and 99.62% 卤0.19kirk, respectively, 84.49% 卤4.27% and 84.69% 卤6.25.The erythrocyte recovery rate and the cleaning rate of each substance between the two groups were 84.49% 卤4.27% and 84.69% 卤6.25.The clearance rates of heparin were 84.49% 卤4.27% and 84.69% 卤6.25respectively. There was no statistical difference in the removal rate (P 0.05). ConclusionTwo kinds of autologous blood collectors have certain influence on the morphology of red blood cells in the process of recovery and washing, but the red blood cells obtained after washing are better than those of blood stored in stock. 2. After washing with two kinds of white body blood collectors, the contents of 23 DPG in erythrocytes were decreased, but they had the same oxygen carrying function as preoperative arterial blood, and were superior to the blood stored in stock. 3. Two kinds of autologous blood recovery machines can get better quality concentrated red blood cells in spinal surgery, which can eliminate FHb and heparin K ion completely and meet the clinical standard. 4. The quality of blood recovery and the effect of blood treatment were similar to those of domestic Jingjing 3000P and Haemonetics Cell Saver5 autologous blood collectors during spinal surgery.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R612

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