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临床输血与检验

临床输血与检验 ›› 2020, Vol. 22 ›› Issue (4): 390-393.DOI: 10.3969/j.issn.1671-2587.2020.04.013

• 临床输血 • 上一篇    下一篇

贮存式自体输血对非停跳冠状动脉旁路移植术患者免疫功能及术后恢复的影响

连萍红, 陈丰梅, 彭红   

  1. 361000 福建, 陆军第七十三集团军医院
  • 收稿日期:2019-12-20 出版日期:2020-08-20 发布日期:2020-08-12
  • 作者简介:连萍红（1975-）, 女, 福建仙游人, 副主任护师, 本科, 主要从事营养学研究, （Tel）13328325566。

The Effects of Autotransfusion of Pre-Stored Blood on Immune Function and Postoperative Recovery in Patients Undergoing Non-stop Coronary Artery Bypass Grafting

LIAN Ping-hong, CHEN Feng-mei, PENG Hong   

  1. Army Hospital of The 73rd Group, Xiamen, Fujian 361000
  • Received:2019-12-20 Online:2020-08-20 Published:2020-08-12

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摘要： 目的 对比贮存式自体输血与异体输血对非停跳冠状动脉旁路移植术患者免疫功能及术后恢复的影响。方法 选取2017年2月至2019年2月在我院择期行非停跳冠状动脉旁路移植术的患者85例, 其中异体输血48例设置为甲组, 贮存式自体血回输37例设置为乙组, 对比两组患者术前及术后24 h血常规、凝血功能及细胞免疫功能, 记录术后辅助通气时间及ICU停留时间。结果 ①术后24 h时两组患者RBC、Hb、PLT及HCT与术前比较下降（P<0.05）, 与甲组相比, 乙组术后24 h时WBC计数降低, RBC、Hb及PLT数值增高（P<0.05）;②与术前相比, 甲组患者术后24 h时CD3+细胞及CD8+细胞百分比降低, CD4+细胞百分比升高（P<0.05）;乙组患者术后24 h时CD4+/CD8+比值高于手术前（P<0.05）;术后24 h时乙组患者CD3+细胞、CD4+/CD8+比值高于甲组, CD8+细胞百分比低于甲组（P<0.05）;③乙组患者术后辅助通气时间及ICU停留时间均少于甲组（P<0.05）。结论 贮存式自体输血可有效提高非停跳冠状动脉旁路移植术患者术后细胞免疫功能, 平衡机体氧供需关系, 减少术后辅助通气时间。

关键词: 贮存式自体输血, 异体输血, 非停跳冠状动脉旁路移植术, 凝血功能, 免疫功能

Abstract: Objective To compare the effects of autotransfusion of pre-stored blood and allogeneic transfusion on the immune function and postoperative recovery of patients undergoing non-stop coronary artery bypass grafting. Methods Eighty-five patients who underwent non-stop coronary artery bypass grafting from February 2017 to February 2019 in our hospital were selected for the study. Among them, 48 patients with allogeneic blood transfusion were set as group A, and 37 patients who voluntarily received autotransfusion of pre-stored blood were set as group B the blood routine, coagulation function, cellular immune function, auxiliary ventilation time and ICU stay time before and after operation were compared between the two groups. Results 1 The RBC, Hb, PLT and HCT of the two groups decreased at 24 hours after operation (P<0.05), WBC of group B was lower than that of group A, RBC, Hb and PLT were higher than that of group A at 24 hours after operation (P<0.05); 2 Compared with before operation, the percentage of CD3+cells and CD8+cells in group A decreased and the percentage of CD4+cells increased at 24 hours after operation (P<0.05), the difference was statistically significant (P<0.05) .At 24 hours after operation, the percentage of CD3+cells and CD4+/CD8+ in group B was higher than that in group A, and the percentage of CD8+cells was lower than that in group A (P<0.05); 3 The time of auxiliary ventilation and ICU stay in group B were less than that in group A (P<0.05). Conclusion Autotransfusion of pre-stored blood can effectively improve the cellular immune function, balance the relationship between oxygen supply and demand, and reduce the time of auxiliary ventilation.

Key words: Autotransfusion, of, pre-stored, blood, Allogeneic, transfusion, Off-pump, coronary, artery, bypass, grafting, Coagulation, function, Immune, function

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