回收红细胞在体内消亡过程的研究

发布时间：2018-06-28 04:27

本文选题：血液回收 + 红细胞　；参考：《遵义医学院》2015年硕士论文

【摘要】：目的:观察手术患者回收红细胞在体内的消亡情况。方法:随机选择51例择期行骨科手术患者(n=51),分为血液回收组(I组,n=27)和对照组(C组,n=24)。两组均分别于术前、术后、术后24h,48h,72h,96h取静脉血测红细胞计数、血红蛋白含量、游离血红蛋白并记录术中失血量和尿量和术后24h,48h,72h的引流量。并于术前、术后、术后24h,48h,72h取静脉血1ml经裂解红细胞、CD14 antibody闭光孵育、Cytofix/CytopermTM Plus Fixation/Permeabilization Kit破膜固定、CD235a室温孵育之后流式细胞仪检测单核细胞、中性粒细胞吞噬红细胞的数量。结果:两组患者术前一般资料无统计学差异。术中I组失血量明显高于对照组,但术后当天两组患者红细胞计数、血红蛋白含量、游离血红蛋白均无明显差异。术后1-3天两组引流量和液体出入量也无明显差异,I组红细胞计数降低、血红蛋白浓度下降的患者数明显高于C组,且I组患者术中血液回收量与术后血红蛋白最低点呈显著负相关(p=0.005)。而两组游离血红蛋白浓度则无明显差异。不论是总的吞噬量还是中性粒细胞的吞噬量,在术后2、3天时,I组都明显高与C组(p0.05)。结论:血液回收在术中能较好地发挥血液保护的作用,减少异体血需要量:但回收红细胞可能在术后2-3天内迅速死亡;回收红细胞的死亡不是血管内破裂而是被单核巨噬细胞系统吞噬。
[Abstract]:Objective: to observe the death of recovered red blood cells (RBC) in patients undergoing surgery. Methods: Fifty-one patients undergoing elective orthopedic surgery were randomly divided into two groups: blood recovery group (group I) and control group (group C). The red blood cell count, hemoglobin content, free hemoglobin and blood loss during operation and urine volume were recorded in both groups before operation and 24 hours after operation, 48 hours after operation and 72 hours after operation, and 72 hours after operation. Before operation, 24 hours after operation, 48 hours and 72 hours after operation, the venous blood 1ml was incubated with CD14 antibody of the lysed red blood cells. After incubating with Cytofix-CytopermTM Plus Fixation / Permeabilization Kit fixed at room temperature, CD235a, the number of monocytes and neutrophils phagocytosis of erythrocytes was measured by flow cytometry. Results: there was no significant difference in preoperative general data between the two groups. The amount of blood loss in group I was significantly higher than that in control group, but there was no significant difference in erythrocyte count, hemoglobin content and free hemoglobin between the two groups on the day of operation. At 1-3 days after operation, there was no significant difference between the two groups in the volume of drainage and the volume of fluid in group I. The number of patients with decreased hemoglobin concentration in group I was significantly higher than that in group C. In group I, there was a significant negative correlation between the volume of blood recovered during operation and the lowest level of hemoglobin after operation (p0. 005). There was no significant difference in free hemoglobin concentration between the two groups. Both the total phagocytosis and the phagocytosis of neutrophilic granulocytes were significantly higher in group I than those in group C (p0.05) 2 days after operation. Conclusion: blood recovery can play a better role in blood protection and reduce the requirement of allogeneic blood. But the recovered red blood cells may die quickly within 2-3 days after operation. The death of the recovered red blood cell is not an intravascular rupture but swallowed by a mononuclear macrophage system.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614

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