自体引流血回输在一期双侧膝关节置换术后的临床应用研究

发布时间：2018-06-20 02:21

本文选题：一期双侧膝关节置换 + 自体血回输　；参考：《广州医科大学》2017年硕士论文

【摘要】：目的:研究自体引流血回输在一期双侧膝关节置换手术当中的临床应用效果。方法:本研究的病例来自广州市第一人民医院关节外科2014年9月至2017年1月收入院并由同一组医生行一期双膝关节置换的患者,于术后使用绿清公司生产的自体血回输器并回输了一定量的术后引流血。通过对引流血成分测定,以及患者术后的自体血回输量、异体血回输量、隐性失血量等数据进行统计学分析,以期探讨自体血会输的安全性和有效性,并同时对自体血回输器在一期双侧膝关节置换当中的临床应用进行讨论。结果:本组研究的30例患者平均自体血回输量为364ml,平均总引流量为758ml,回输量占总引流量的48%,平均隐性失血量为926ml,平均异体血输血量为250ml,异体血输血率为50%。术后1、3、7天的静脉血HB、RBC、HCT较之术前出现明显的下降,术后第3天达到最低值,与术前相比并具有统计学意义(p0.05);术后钾离子、钙离子及黄疸三项水平均在正常值范围内;引流血血涂片染色见红细胞形态保持完整,未见红细胞碎片,引流血HB、RBC、HCT较之术前出现了明显的下降,并具有统计学意义(p0.05),引流血黄疸三项水平在正常值范围内,血钾水平升高,血钙水平降低;本组研究的所有病例在自体血回收的过程当中未出现发热、过敏、溶血性黄疸等情况。结论:自体血回输器在一期双侧膝关节置换的临床应用中是安全有效的,可以减少患者异体血的输注量和输注率。
[Abstract]:Objective: to study the clinical effect of autologous drainage blood transfusion in one-stage bilateral knee arthroplasty. Methods: the patients in this study were admitted to our hospital from September 2014 to January 2017 and underwent one-stage double knee arthroplasty by the same group of doctors, from September 2014 to January 2017 in the first people's Hospital of Guangzhou. The autologous blood transfusion device produced by Green Qing Company was used after operation and a certain amount of postoperative bleeding was reinfused. In order to explore the safety and effectiveness of autologous blood transfusion, the data of autologous blood transfusion, allogeneic blood transfusion, recessive blood loss and so on were analyzed statistically, so as to explore the safety and effectiveness of autologous blood transfusion. At the same time, the clinical application of autologous blood transfusion in one-stage bilateral knee arthroplasty was discussed. Results: the average volume of autologous blood transfusion was 364 ml, the average total drainage volume was 758 ml, the average volume of recessive blood loss was 926 ml, the average volume of allogeneic blood transfusion was 250 ml, and the rate of allogeneic blood transfusion was 50 ml. The HCT of HBT in venous blood of 7 days after operation was significantly lower than that before operation, and reached the lowest value on the third day after operation, which was statistically significant compared with that before operation (P 0.05), and the levels of potassium ion, calcium ion and jaundice were within the normal range after operation. Blood smear staining showed that erythrocyte morphology remained intact, no red blood cell fragments were found, and the HCT of HBT in the drained blood decreased significantly compared with that before operation, and had statistical significance (P 0.05). The three levels of jaundice in draining blood were in the normal range, and the serum potassium level was increased. There was no fever, anaphylaxis, hemolytic jaundice and so on. Conclusion: the autologous blood transfusion device is safe and effective in the clinical application of one stage bilateral knee arthroplasty, which can reduce the transfusion volume and transfusion rate of allogeneic blood.
【学位授予单位】：广州医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

【相似文献】