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目的:探讨不加抗凝剂自体血回输在创伤性腹腔内出血患者中应用的可行性。方法:以非抗凝自体血回输的45例创伤性腹腔内出血患者为研究对象。观察围术期患者心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、中心静脉压(CVP)、血氧饱和度(SpO2)以及自体血回输前后血红蛋白(Hb)、血细胞比容(HCT)和血小板(PLT),同时测定红细胞C3b受体花环形成率(RBC-C3bRR)、红细胞免疫复合物花环形成率(RBC-ICR)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平。结果:1自体血液回输后及术后24h与回输前及术前比较SBP、MAP及CVP明显升高(P<0.05),HR明显下降(P<0.05);2自体血液回输后与回输前比较Hb和HCT明显升高(P<0.05),PLT明显降低(P<0.05);RBC-C3bRR和RBC-ICR明显降低(P<0.05),但IL-6和TNF-α水平明显升高(P<0.05)。结论:在腹腔大出血回收过程中不加抗凝剂回输可减少对患者凝血功能的影响,避免出血倾向,值得临床推广应用。
Objective: To investigate the feasibility of autologous blood transfusion without anticoagulants in traumatic intra-abdominal hemorrhage. Methods: Forty-five patients with traumatic intra-abdominal hemorrhage transfused with non-anticoagulated autologous blood were enrolled in this study. The changes of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), central venous pressure (CVP), oxygen saturation (SpO2) and perioperative hemoglobin (RBC-C3bRR), erythrocyte immune complex rosette formation rate (RBC-ICR), interleukin-6 (Hb), hematocrit (HCT) and platelet (PLT) IL-6) and tumor necrosis factor-α (TNF-α) levels. Results: 1 SBP, MAP and CVP significantly increased (P <0.05) and HR decreased significantly (P <0.05) after autologous blood transfusion and 24h before and after transfusion; The levels of Hb and HCT were significantly increased (P <0.05), PLT was significantly decreased (P <0.05), RBC-C3bRR and RBC-ICR were significantly decreased (P <0.05), but the level of IL-6 and TNF- Increased (P <0.05). Conclusion: In the process of intraperitoneal hemorrhage recovery without anticoagulant infusion can reduce the impact of coagulation function in patients with bleeding tendency, it is worth clinical application.