术中回收式自体血回输对肝炎后门脉高压症患者肝炎病毒载量的影响

发布时间：2018-07-10 20:22

本文选题：门脉高压 + 自体血回输　；参考：《吉林大学》2015年硕士论文

【摘要】：目的：探究肝炎后门脉高压症患者脾切断流术中应用回收式自体血回输其对肝炎病毒载量的影响，以及病毒载量的改变率与回输血量的相关性。方法：收集吉林大学第一医院肝胆胰外科2014年7月至2015年3月收治的15例乙型肝炎后肝硬化门静脉高压症行脾切断流术并于术中应用回收式自体血回输的患者的临床资料，采用PCR酶联化学发光法测定患者术前及术后3天的HBV DNA定量，常规检测术前及术后1天晨起外周血血红蛋白值，，计算术前、术后病毒载量的改变率，并利用SPSS19.0软件进行数据统计学分析。结果： ①15例患者术中回收式自体血回输后均未出现溶血反应、发热反应。 ②15患者术前、术后外周血血红蛋白值分别为（104.24.5）g/L和（113.93.7）g/L，术后较术前明显升高且存在显著性差异（P=0＜0.05）。 ③15患者术前、术后HBV DNA定量分别为（277252.4147254.2）IU/ml和（211063.1133620.4）IU/ml，术前、术后HBV DNA无显著性差异（P=0.435＞0.05）。 ④15例患者术前、术后HBV DNA改变率与回输血量不相关，其pearson相关系数为-0.713。结论：肝炎后门脉高压症患者脾切断流术中应用回收式自体血回输技术安全有效，可明显提高患者术后的血红蛋白值水平从而减少血制品的用量。术中应用回收式自体血回输对其病毒载量无明显影响，且病毒定量的改变率与回输血量不相关，但仍需要大样本的随机化前瞻性研究证据支持，同时需要对照实验排除脾脏血的影响。
[Abstract]:Objective:
To explore the effect of reclaimed autologous blood transfusion on the load of hepatitis virus, and the correlation between the rate of change of viral load and the amount of blood transfusion during the splenectomy for patients with posterior portal hypertension of hepatitis.
Method:
The clinical data of 15 patients with portal hypertension in the liver and cirrhosis of the liver treated in the No.1 Hospital of Jilin University from July 2014 to March 2015 were collected and the clinical data of reclaimed autologous blood transfusion were used in the operation. The PCR chemiluminescence method was used to determine the HBV DNA quantity before and 3 days after the operation. The hemoglobin values of peripheral blood before and 1 days after operation were measured before and after operation. The change rate of viral load before and after operation was calculated and statistically analyzed by SPSS19.0 software.
Result:
There was no hemolytic reaction and fever reaction in 15 patients after the recovery of autologous blood transfusion.
(15) before operation, the hemoglobin value of peripheral blood was (104.24.5) g/L and (113.93.7) g/L after operation, and there was significant difference after operation (P=0 < 0.05).
(3) before operation, the HBV DNA was (277252.4147254.2) IU/ml and (211063.1133620.4) IU/ml after operation, and there was no significant difference between HBV DNA before and after operation (P=0.435 > 0.05).
(4) there was no correlation between the change of HBV DNA and the amount of blood transfusion in 15 patients before and after operation, and the correlation coefficient of Pearson was -0.713.
Conclusion:
The recovery of autologous blood transfusion is safe and effective in the operation of the splenectomy for the patients with posterior portal hypertension, which can obviously improve the hemoglobin level of the patients and reduce the amount of blood products. The use of the reclaimed autologous blood transfusion during the operation has no obvious effect on the viral load, and the rate of change of the virus quantitative and the amount of the blood transfusion is not similar. However, large sample randomized trial is needed to support the evidence. Meanwhile, a controlled experiment is needed to exclude the effects of splenic blood.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.34

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