摘要
目的复杂脊柱手术患者手术过程中往往需要大量输血,本研究探讨术前预存式自体输血联合术中自体血回输在复杂脊柱手术中的应用价值。方法选择2017-11-01—2018-11-01浚县人民医院收治的进行复杂脊柱手术治疗的80例患者作为研究对象。按照组间性别、年龄等因素均衡可比的原则选择观察组和对照组,各40例。观察组手术前预存自体血,对照组手术前不预存自体血。观察术中情况、血红蛋白(hemoglobin,Hb)、白细胞(white blood cell,WBC)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor alpha,TNF-α)、白细胞介素-4(interleukin-4,IL-4)和白细胞介素-10(interleukin-10,IL-10)变化情况。结果观察组手术时间为(139.28±13.45)min,短于对照组的(145.28±12.99)min,t=2.029,P=0.023。观察组术后4dIL-6水平为(57.49±8.14)ng/mL,低于对照组的(96.38±8.65)ng/mL,t=20.708,P<0.001。观察组术后1、4和7dTNF-α水平分别为(140.08±14.26)、(128.87±24.18)和(93.64±7.21)ng/mL,低于对照组的(146.01±12.34)、(142.88±31.18)和(98.89±6.44)ng/mL,t值分别为1.989、2.246和3.435,P值分别为0.047、0.034和0.001;观察组术后1、4和7dIL-4水平分别为(23.88±6.45)、(19.48±4.62)和(6.69±1.25)ng/mL,低于对照组的(45.59±7.24)、(29.99±5.45)和(19.66±4.18)ng/mL,t值分别为14.161、9.304和18.802,均P<0.001;观察组术后1、4和7dIL-10水平分别为(2.58±0.87)、(3.09±0.58)和(3.09±0.76)ng/mL,低于对照组的(7.08±1.54)、(6.18±1.24)和(5.08±0.78)ng/mL,t值分别为16.091、14.276和11.557,均P<0.001。结论术前预存式自体输血联合术中自体血回输在复杂脊柱手术中的应用价值较高,可以减轻机体的炎性反应,提高输血效果。
OBJECTIVE A large amount of blood transfusion is often needed in the operation of patients with complex spine surgery.This study explores the application value of preoperative autotransfusion combined with intraoperative autotransfusion in complex spine surgery.METHODS A total of 80 patients who underwent complex spinal surgery in Xunxian People’s Hospital from November 1,2017 to November,1,2018 were selected as the study subjects.According to the principle of balanced and comparable gender and age among groups,the observation group and the control group were selected,40 cases in each group.Autologous blood was reserved in the observation group before operation,but not in the control group before operation.The intraoperative conditions,hemoglobin(Hb),white blood cell(WBC),interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),interleukin-4(IL-4),interleukin-10(IL-10)were observed.RESULTS The operation time of the observation group was(139.28±13.45)min,which was shorter than that of the control group(145.28±12.99)min,t=2.029,P=0.023.On the 4 th day after operation,the level of IL-6 in the observation group was(57.49±8.14)ng/ml,lower than that in the control group(96.38±8.65)ng/ml,t=20.708,P<0.001.The level of TNF-αin the observation group at 1,4 and 7 days after operation were(140.08±14.26),(128.87±24.18)and(93.64±7.21)ng/ml,respectively,lower than those in the control group(146.01±12.34),(142.88±31.18)and(98.89±6.44)ng/ml,with t values of 1.989,2.246 and 3.435,Pvalues of 0.047,0.034 and 0.001.The level of IL-4 on day 1,4 and 7 were(23.88±6.45),(19.48±4.62)and(6.69±1.25)ng/ml,respectively,lower than those in the control group(45.59±7.24),(29.99±5.45)and(19.66±4.18)ng/ml,with t values of 14.161,9.304 and 18.802,respectively,all P<0.001;The level of IL-10 in the observation group at 1,4 and 7 days after operation were(2.58±0.87),(3.09±0.58)and(3.09±0.76)ng/ml,lower than those in the control group(7.08±1.54),(6.18±1.24)and(5.08±0.78)ng/ml,witht values of 16.091,14.276 and 11.557,respectively,all P<0.001.CONCLUSION Preoperative reserved autotransfusion combined with intraoperative autotransfusion is of high value in complex spinal surgery,which can reduce the inflammatory reaction of the body and improve the effect of blood transfusion.
作者
竹怀春
王红霞
ZHU Huai-chun;WANG Hong-xia(Department of Anesthesiology,Xunxian People's Hospital,Xunxian456250,P.R.China)
出处
《社区医学杂志》
2019年第23期1495-1498,共4页
Journal Of Community Medicine
关键词
术前预存式自体输血
术中自体血回输
复杂脊柱手术
炎性因子
pre-operative autologous blood transfusion
intraoperative autologous blood transfusion
complex spinal surgery
inflammatory factor
作者简介
通讯作者:竹怀春,男,河南固始人,主治医师,主要从事自体血回收技术应用的研究工作。Tel:86-392-5566827 E-mail:zhangpingwasd@163.com
