目的探讨预存式自体输血和异体输血对老年脑外科手术患者脑组织氧合和乳酸代谢的影响。方法我院确诊治疗的脑外科手术患者86例,按随机数字表法分为自体组和异体组各43例。异体组给予异体输血治疗,自体组给予预存式自体血回输治疗,比较...目的探讨预存式自体输血和异体输血对老年脑外科手术患者脑组织氧合和乳酸代谢的影响。方法我院确诊治疗的脑外科手术患者86例,按随机数字表法分为自体组和异体组各43例。异体组给予异体输血治疗,自体组给予预存式自体血回输治疗,比较两组术前、术后脑氧合代谢指标和认知功能,血清TNF-α、IL-6和IL-10水平,术后并发症和输血不良反应发生情况。结果自体组术后1、3、7 d脑氧耗、乳酸生成量低于异体组,脑氧摄取率高于异体组;术后3 d Mo CA评分高于异体组;术后7 d TNF-α、IL-10水平高于异体组,IL-6水平低于异体组;并发症和输血不良反应发生率均低于异体组(P<0.05)。结论预存式自体输血可改善脑外科手术患者脑氧合代谢指标和认知功能,降低术后炎性反应,减少感染性并发症和输血不良反应发生率,有利于术后转归。展开更多
目的探讨氨甲环酸(TXA)减少全膝关节置换术(TKA)患者围手术期出血及对自体引流血回输和术后异体输血的影响。方法采用前瞻性随机对照方法,纳入2014年6月-2015年6月本院因膝重度骨性关节炎接受单侧人工TKA患者60名,随机分为A组(处理组:...目的探讨氨甲环酸(TXA)减少全膝关节置换术(TKA)患者围手术期出血及对自体引流血回输和术后异体输血的影响。方法采用前瞻性随机对照方法,纳入2014年6月-2015年6月本院因膝重度骨性关节炎接受单侧人工TKA患者60名,随机分为A组(处理组:术中及术后氨甲环酸15 mg/kg静滴);B组(对照组:术中及术后同等剂量0.9%生理盐水静滴)。收集对比2组患者性别、年龄、身高、体重数据,以及术前及术后Hb、Hct,手术时长,术中出血量,术后引流量,自体引流血回输量、术后异体输血量,以及输血例数,髌上10 cm周径。用Gross方程计算患者围手术期隐性出血量及总计出血量。结果 A与B组术后引流量(m L)分别为220.37±168.6 vs 598.67±234.33;隐性出血量(m L)494.67±371.08 vs 726.75±357.48及总计出血量(m L)715.03±389.06 vs 1 325.42±422.74(均为P<0.05)。A与B组的异体输血率分别为0 vs 6.7%(2/30)。A与B组自体引流血回输量(m L)30±76.76 vs 283±111.45(P<0.05)。结论氨甲环酸可减少全膝关节置换术患者的术后出血,减少术后异体输血及自体引流血回输。展开更多
Intraoperative blood salvage autotransfusion (IBSA) is used in various surgical procedures. However, because of the risk of reinfusion of salvaged blood contaminated by tumor cells, the use of IBSA in hepatocellular c...Intraoperative blood salvage autotransfusion (IBSA) is used in various surgical procedures. However, because of the risk of reinfusion of salvaged blood contaminated by tumor cells, the use of IBSA in hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT) is controversial. The critical points include whether tumor cells can be cleared by IBSA, whether IBSA increases the risk of recurrence or metastasis, and what are the indications for IBSA. Moreover, is it warranted to take the risk of tumor dissemination by using IBSA to avoid allogeneic blood transfusion? Do the remaining tumor cells after additional filtration by leukocyte depletion filters still possess potential tumorigenicity? Does IBSA always work well? We have reviewed the literature and tried to address these questions. The available data indicate that IBSA is safe in LT for HCC, but randomized, controlled and prospective trials are urgently required to clarify the uncertainty.展开更多
文摘目的探讨预存式自体输血和异体输血对老年脑外科手术患者脑组织氧合和乳酸代谢的影响。方法我院确诊治疗的脑外科手术患者86例,按随机数字表法分为自体组和异体组各43例。异体组给予异体输血治疗,自体组给予预存式自体血回输治疗,比较两组术前、术后脑氧合代谢指标和认知功能,血清TNF-α、IL-6和IL-10水平,术后并发症和输血不良反应发生情况。结果自体组术后1、3、7 d脑氧耗、乳酸生成量低于异体组,脑氧摄取率高于异体组;术后3 d Mo CA评分高于异体组;术后7 d TNF-α、IL-10水平高于异体组,IL-6水平低于异体组;并发症和输血不良反应发生率均低于异体组(P<0.05)。结论预存式自体输血可改善脑外科手术患者脑氧合代谢指标和认知功能,降低术后炎性反应,减少感染性并发症和输血不良反应发生率,有利于术后转归。
文摘目的探讨氨甲环酸(TXA)减少全膝关节置换术(TKA)患者围手术期出血及对自体引流血回输和术后异体输血的影响。方法采用前瞻性随机对照方法,纳入2014年6月-2015年6月本院因膝重度骨性关节炎接受单侧人工TKA患者60名,随机分为A组(处理组:术中及术后氨甲环酸15 mg/kg静滴);B组(对照组:术中及术后同等剂量0.9%生理盐水静滴)。收集对比2组患者性别、年龄、身高、体重数据,以及术前及术后Hb、Hct,手术时长,术中出血量,术后引流量,自体引流血回输量、术后异体输血量,以及输血例数,髌上10 cm周径。用Gross方程计算患者围手术期隐性出血量及总计出血量。结果 A与B组术后引流量(m L)分别为220.37±168.6 vs 598.67±234.33;隐性出血量(m L)494.67±371.08 vs 726.75±357.48及总计出血量(m L)715.03±389.06 vs 1 325.42±422.74(均为P<0.05)。A与B组的异体输血率分别为0 vs 6.7%(2/30)。A与B组自体引流血回输量(m L)30±76.76 vs 283±111.45(P<0.05)。结论氨甲环酸可减少全膝关节置换术患者的术后出血,减少术后异体输血及自体引流血回输。
文摘Intraoperative blood salvage autotransfusion (IBSA) is used in various surgical procedures. However, because of the risk of reinfusion of salvaged blood contaminated by tumor cells, the use of IBSA in hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT) is controversial. The critical points include whether tumor cells can be cleared by IBSA, whether IBSA increases the risk of recurrence or metastasis, and what are the indications for IBSA. Moreover, is it warranted to take the risk of tumor dissemination by using IBSA to avoid allogeneic blood transfusion? Do the remaining tumor cells after additional filtration by leukocyte depletion filters still possess potential tumorigenicity? Does IBSA always work well? We have reviewed the literature and tried to address these questions. The available data indicate that IBSA is safe in LT for HCC, but randomized, controlled and prospective trials are urgently required to clarify the uncertainty.
