摘要
目的探讨不同方法自体血回输对输卵管妊娠破裂患者炎性因子的影响。方法全身麻醉下行输卵管妊娠破裂出血手术治疗患者45例,随机分为肝素组(H组)、枸橼酸钠组(C组)、白细胞滤器组(LDF组),每组15例。术中均进行自体血回收,H组肝素抗凝,C组枸橼酸钠抗凝、LDF组肝素抗凝,回输时使用白细胞滤器。分别在麻醉诱导前即刻(T1)、自体血回输前(T2)、回输后1h(T3)、回输后12h(T4)、回输后24h(T5)、回输后48h(T6)抽取静脉血检测血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)水平。结果与T1比较,TNF-α在T3和T6时明显升高(P<0.01),IL-6、IL-8在T3、T4、T5时逐渐升高(P<0.01),T6时回落(P<0.01),IL-10在T2后持续升高(P<0.01)。与H组比较,C组和LDF组患者T3时TNF-α水平明显低于H组(P<0.01),T3、T4、T5、T6时IL-6、IL-8、IL-10水平低于H组(P<0.05或P<0.01);与C组比较,LDF组患者T3时TNF-α水平低于C组(P<0.05),T3、T4、T5、T6时IL-6、IL-8、IL-10水平低于C组(P<0.05或P<0.01)。结论运用肝素或枸橼酸钠抗凝进行自体血回输,患者血浆TNF-α、IL-6、IL-8、IL-10水平不同程度增高,自体血回输时使用白细胞滤器,能有效减少各炎性因子的释放。
Objective To investigate the effect of different methods of autologous bloodtransfusion on inflammatory factors of tubal pregnancy bleeding patients.Methods Forty-five patients of tubal pregnancy received surgical management undergoing general anesthesiawere divided randomly and equally into heparin group（group H）,sodium citrate group（group C）and leukoecytedeplection filter group（group LDH）,15 patients in each group.Intraoperative blood salvage was used in every patient.Patients in group H were used heparin anticoagulation,patients in group C were used sodium citrate anticoagulation,patients in group LDH were used heparin anticoagulation,then leukoecyte filter was used during autologous blood transfusion.The serum levels of TNF-α,IL-6,IL-8,IL-10 were observed before anesthesia（T1）,before autologous blood transfusion（T2）,1 hour after transfusion（T3）,12 hour after transfusion（T4）,24 hour after transfusion（T5）,48 hour after transfusion（T6）.Results Compared with T1,the level of TNF-αwas significantly higher than that in T3 and T6（P〈0.01）,IL-6,IL-8 were increased gradually at T3,T4,T5（P〈0.01）and declined at T6（P〈0.01）,IL-10 gradually rised after T2（P〈0.01）in three groups.Compared with H group,TNF-αof C group and LDF group were significantly lower than H group at T3（P〈0.01）,IL-6,IL-8,IL-10 were lower than those of group H at T3,T4,T5,T6（P〈0.05 or P〈0.01）;Compared with C group,TNF-αof LDF group was lower than C group at T3（P〈0.05）,IL-6,IL-8,IL-10 were lower than those of group C at T3,T4,T5,T6（P〈0.05 or P〈0.01）.Conclusion As anticoagulants for autotransfusion,heparin or sodium citrate can lead to increase TNF-α,IL-6,IL-8,IL-10 in different degrees.The use of leukoecytedeplection filter for autologous blood transfusion can effectively reduce the release of inflammatory factors above.
作者
刘娜
马庆杰
金华
LIU Na;MA Qingjie;JIN Hua(Department of Anesthesiology,the First Pepole′s Hospital of Yunnan Provinc)
出处
《检验医学与临床》
CAS
2018年第4期436-438,共3页
Laboratory Medicine and Clinic
基金
国家自然科学基金资助项目(81300973)
关键词
肝素
血液滤过
自体血液回收
炎性因子
heparin
hemofiltration
blood salvage
inflammatory factors
