协和医学杂志Issue(1)：9-13,5.DOI:10.3969/j.issn.1674-9081.2015.01.002
少量出血患者使用术中回收式自体输血有效性的随机对照研究
Effectiveness of Intraoperative Autotransfusion in Mild-bleeding Surgery:a Randomized Controlled Trial
摘要
Abstract
Objective To investigate the effectiveness of intraoperative autotransfusion ( IAT) in impro-ving tissue oxygenation and postoperative recovery in patients undergoing mild -bleeding surgery .Methods We selected patients scheduled for posterior lumbar surgery at Peking Union Medical College Hospital from December 2011 to April 2012 , at American Soceity of Anesthesiologists grade Ⅰ-Ⅱ, and with estimated blood loss less than 20%of their blood volume .The patients were randomly divided into the IAT group ( given salvaged autologous blood) and the control group (given equal volume of colloid solution instead ).Hemoglobin (Hb) level, lactate level, and cerebral oxygen saturation before , during, and after the surgery were compared between the two groups . Postoperative recovery indexes of the 2 groups were compared , including body temperature , chief complaint , wound healing , ambulation time , and postoperative length of stay .Results Thirty-eight patients were enrolled and randomly divided into the IAT group (n=19) and the control group (n=19).In the IAT group, postop-erative half-hour and postoperative 1-day Hb levels were (116.5 ±10.7) g/L and (115.4 ±12.3) g/L, re-spectively, both significantly higher than the intraoperative level [(106.6 ±12.6) g/L; P =0.001, P =0.004 ];while no such significant differences were found in the control group ( P>0.05 ) .Lactate level was significantly elevated at postoperative half-hour compared with preoperative level in the control group [ (2.5 ± 1.0) mmol/L vs.(1.3 ±0.6) mmol/L, P=0.016], while the trend was absent in the IAT group.There were no significant differences in postoperative Hb level , lactate level, and cerebral oxygen saturation between the two groups ( P>0.05 ) , nor in any of the postoperative recovery indexes ( P>0.05 ) .Conclusion The use of IAT in healthy adult patients undergoing surgery with estimated small blood loss could improve early tis-sue oxygenation after the surgery , but with no significant influence on postoperative recovery .关键词
术中回收式自体输血/输血指征/组织氧合Key words
intraoperative autotransfusion/transfusion indication/tissue oxygenation分类
医药卫生引用本文复制引用
李晗歌,张志永,黄宇光,虞雪融..少量出血患者使用术中回收式自体输血有效性的随机对照研究[J].协和医学杂志,2015,(1):9-13,5.基金项目
卫生行业科研基金 （）
