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目的探讨预存联合术中回收式自体输血对择期手术患者的临床效果。方法采用随机数字法将84例择期手术患者随机分为2组,每组42例。对照组给予异体输血,观察组给予预存联合术中回收式自体输血。治疗前后,检测患者血液相关指标(Hb、Hct、PLT、PT、APTT)、炎症介质(TNF-α、补体C3)、外周血T淋巴细胞亚群(CD4、CD4/CD8、CD8)和NK细胞、免疫球蛋白(IgA、IgG、IgM)水平,并统计不良反应发生情况。结果治疗后,观察组Hb、HCT、PLT、PT、APTT水平与治疗前比较差异无统计学意义(P>0.05);对照组Hb、HCT、PLT、PT、APTT水平则明显下降(P<0.05);且观察组Hb、HCT、PLT、PT、APTT水平显著高于对照组(P<0.05)。治疗后,观察组补体C3、CD4、CD4/CD8、NK细胞、IgA、IgG、IgM水平与治疗前比较显著升高(P<0.05);对照组补体C3、CD4、CD4/CD8、NK细胞、IgA、IgG、IgM水平则明显下降(P<0.05);而且观察组补体C3、CD4、CD4/CD8、NK细胞、IgA、IgG、IgM水平明显高于对照组(P<0.05)。治疗后,观察组TNF-α显著降低,而对照组TNF-α显著升高,且观察组TNF-α显著低于对照组(P<0.05)。观察组不良反率为0.0%,显著低于对照组的14.3%(P<0.05)。结论相比于异体输血,预存联合术中回收式自体输血可有效调节患者炎症和免疫功能,利于预后恢复。
Objective To investigate the clinical effect of recurrent autologous blood transfusion in patients undergoing elective surgery during preoperative combined surgery. Methods 84 patients undergoing elective surgery were randomly divided into two groups (n = 42 in each group) using random number method. The control group was given allogeneic blood transfusion, the observation group was given the preoperative combined intraoperative recovery autologous blood transfusion. Before and after treatment, the levels of blood related indicators such as Hb, Hct, PLT, PT and APTT, inflammatory mediators (TNF-α and complement C3), peripheral blood T lymphocyte subsets (CD4, CD4 / CD8 and CD8) and NK cells , Immunoglobulin (IgA, IgG, IgM) levels, and statistics of adverse reactions. Results After treatment, the levels of Hb, HCT, PLT, PT and APTT in the observation group were not significantly different from those before the treatment (P> 0.05); the levels of Hb, HCT, PLT, PT and APTT in the control group were significantly decreased ). The levels of Hb, HCT, PLT, PT and APTT in the observation group were significantly higher than those in the control group (P <0.05). After treatment, the levels of complement C3, CD4, CD4 / CD8, NK cells, IgA, IgG and IgM in the observation group were significantly higher than those before treatment (P <0.05) (P <0.05). The levels of complement C3, CD4, CD4 / CD8, NK cells, IgA, IgG and IgM in the observation group were significantly higher than those in the control group (P <0.05). After treatment, the levels of TNF-α in the observation group were significantly decreased, while the levels of TNF-α in the control group were significantly increased, and the levels of TNF-α in the observation group were significantly lower than those in the control group (P <0.05). The adverse reaction rate was 0.0% in the observation group, which was significantly lower than that in the control group (14.3%, P <0.05). Conclusion Compared with allogeneic blood transfusion, the preoperative combined intraoperative recovery of autologous blood transfusion can effectively regulate the inflammation and immune function of patients, which will benefit the recovery of prognosis.