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目的:探讨急性等容血液稀释(ANH)联合术中血液回收(IBS)对脊柱骨折手术患者术中血液保护的效果。方法:采用回顾性病例对照研究分析2016年1月至2019年10月成都市第一人民医院收治的111例胸腰椎骨折患者临床资料，其中男61例，女50例；年龄27～64岁[(44.6±8.3)岁]。损伤节段：Tn 11～Ln 1 30例，Tn 10～Ln 1 45例，Tn 11～Ln 2 30例，Ln 1～Ln 3 6例。患者均行后路减压椎弓根螺钉固定术治疗。37例应用ANH进行血液保护(A组)，37例应用IBS进行血液保护(B组)，37例应用ANH联合IBS进行血液保护(C组)。记录A组和C组放血前(Tn 0)、放血后10 min(Tn 1)、自体血回输前(Tn 2)、回输血结束后30 min(Tn 3)4个时相点平均动脉压(MAP)、中心静脉压(CVP)、心率(HR)、血红蛋白(Hb)、红细胞压积(Hct)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)；B组于麻醉诱导后10 min(Tn 0)、手术开始前(Tn 1)、自体血回输前(Tn 2)及回输血结束30 min后(Tn 3)记录检测相同指标。比较三组术中失血量、异体红细胞输注量及输注率、新鲜冰冻血浆输注量及输注率、术后感染发生率及住院时间。n 结果:Tn 0时，三组MAP、CVP、HR差异无统计学意义(n P>0.05)；Tn 1时，A、C组MAP较B组降低(n P0.05)。三组术后感染发生率[5%(2/37) ∶8%(3/37) ∶8%(3/37)]及住院时间[(10.9±2.7)d ∶(12.0±3.1)d ∶(11.0±2.2)d]差异均无统计学意义(n P>0.05)。n 结论:对脊柱骨折手术患者而言，ANH联合IBS可以减少术中异体输血需求，对血流动力学、凝血功能无不良影响，可以安全应用于临床。“,”Objective:To investigate the efficacy of acute normovolemic hemodilution (ANH) combined with intraoperative blood salvage (IBS) in blood-conservation for spinal fracture surgery.Methods:A retrospective case-control study was conducted to analyze the clinical data of 111 patients with thoracolumbar fractures admitted to Chengdu First People's Hospital from January 2016 to October 2019. There were 61 males and 50 females, aged 27-64 years [(44.6±8.3)years]. In terms of the injured segments, there were 30 patients with Tn 11-Ln 1, 45 with Tn 10-Ln 1, 30 with Tn 11-Ln 2, and 6 with Ln 1-Ln 3. All patients underwent posterior decompression pedicle screw fixation. Thirty-seven patients received ANH for blood conservation (Group A), 37 patients received IBS for blood conservation (Group B), and 37 patients received ANH combined with IBS for blood conservation (Group C). The mean arterial pressure (MAP), central venous pressure (CVP), heart rate (HR), hemoglobin concentration (Hb), hematocrit (Hct), prothrombin time (PT), and activated partial thrombin time (APTT) were recorded in Group A and C before blood drainage (Tn 0), 10 minutes after blood drainage (Tn 1), and before (Tn 2) and 30 minutes after (Tn 3) retransfusion. Whereas in Group B the same parameters were measured 10 minutes after anesthesia induction (Tn 0), before surgery (Tn 1), and before (Tn 2) and 30 minutes after (Tn 3) transfusion of autologous blood. Intra-operative blood loss, volume of allogenic red blood cell transfusion, rate of allogenic red blood cell transfusion, volume of fresh frozen plasma transfusion, rate of fresh frozen plasma transfusion, incidence of postoperative infection, and length of hospital stay were recorded and compared among the three groups.n Results:There were no significant differences in MAP, CVP and HR between the three groups at Tn 0 (n P>0.05). The levels of MAP in Group A and C were lower than that in Group B at Tn 1 (n P0.05). Postoperative infection [5%(2/37) ∶8%(3/37) ∶8%(3/37)] and length of hospital stay[(10.9±2.7)days ∶(12.0±3.1)days ∶(11.0±2.2)days] showed no significant difference among Group A, B and C (n P>0.05).n Conclusion:For the spinal fracture surgery, ANH combined with IBS can reduce the intraoperative need for allogenic transfusion and have no adverse effects on hemodynamics and coagulation function, which can be safely applied in clinical practice.