自体血回输在颅脑手术中的应用研究

作者：王淑芬　邹娟　曹晓燕　柴红

摘要：自1999年5月，采用“自体-2000型血液回收机”，用于颅脑手术85例，均将术中出血通过吸引罐回收，大量生理盐水冲洗后，再分离、净化处理后回输给患者，共计回收血液44 085 ml。回收血RBC、HGB及Hct与患者血相比无显著差异，血气及电解质分析证实，回收血PO2明显高于患者静脉血和库血，自体血优于异体血。因此，自体血在颅脑外科应用效果较好，既解决血源紧张，又避免疾病传播，特别是用于颅内动脉瘤夹闭与切除术时出现破裂，可快速将患者血液回输，提高抢救成功率，保证手术顺利进行。
关键词：自体输血； 颅脑手术
中图分类号：R472.3　　文献标识码：A
文章编号：1008-9993(2000)02-0008-03

Application of Intraoperative Autotransfusion in Cerebral Surgery

WANG Shu-fen,ZOU Juan,CAO Xiao-yan,Cai hong
(Department of Operation,General Hospital of Shenyang Command,PLA,Shenyang,110015，China)

Abstract：The autologous-2 000 blood recovery system has been used in our hospital to conduct cerebral operation since May 1999,the number is total to 85.We first recovered the blood by the suction bottle,cleaned it by massive physiological saline and then dissociated and depurated it,finally we transfused it back to the patient.The recovered blood volume amounted to 44 085 ml.There was no significant difference between the recovered blood and the banked blood,which was proved by blood gas and electrolyte analysis.Autotransfusion was better than the homologous blood infusion.Therefore the use of autotransfusion in the cerebral surgery has obvious advantage.It can not only solve the shortage of blood source,but also avoid disease spreading.Especially in cerebral aneurism clip and resection,as the aneurysm ruptured,autotransfusion can transfuse the recovered blood back to the patient quickly,increase the probability of salvage and guarantee to carry out the operation successfully.
Key words:autotransfusion; cerebral surgery

　　随着神经外科手术的发展，颅脑手术用血量逐年增加，由于血源紧张，血液供不应求，神经外科手术又经常出现意外大出血，造成有效血液循环难以维持，甚至危及生命。自体血回输是解决血源不足的重要途径。我院自1999年5月购进“自体－2000型血液回收机”，共实施颅脑手术85例，均将术中出血回收处理后再输给患者，节约了血液资源，避免了疾病传播，收到了很好的效果。现将临床应用效果报告如下：

1　临床资料
　　85例患者中男47例，女38例，年龄17～72岁，平均(38±18)岁；体重45～85.5 kg，平均(58.75±20.29) kg。其中脑膜瘤切除术32例，动脉瘤夹闭及切除21例，脑占位病变1

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