目的:探討自體血液回收技術對循環、血細胞和凝血功能的影響及應用效果。方法: 選擇急診大失血手術患者27例,采用ZITI-2000型血液回收機回收血液,經過濾、離心、清洗后回輸給患者。分不同時點觀察HR、SBP、MAP、DBP、SPO2的變化,并監測RBC、Plt、HB、Hct、FIB、PT、APTT的變化。計算輸血量和異體輸血率。隨機選擇8例進行回收原血和回輸 血血細胞學比較。結果:(1)術前血壓較低,心率較快,回輸血液后,HR顯著降低(Plt;0.01),SBP和MAP顯著升高(Plt;0.01)。(2)術前RBC、HB和Hct均低于正常水平,回輸后各時點均升高明顯(Plt;0.01)。術前FIB和Plt低于正常水平,回輸后各時點增高,但無顯著意義。PT、APTT無明顯變化。(3)回收原血平均每例3735mL,回輸血平均每例1589mL,異體輸血率為25％。(4)回輸血RBC、HB和Hct均顯著高于回收原血(Plt;0.01)。結論:自體血液回收技術用于臨床安全可靠,能有效維持循環的穩定,對凝血功能無明顯影響,節約血源,減少異體輸血。
Objective To explore ability of deformation ,small deformation, orientation and in vivo half-life of erythrocytes following intraoperative autotransfusion by ZITI-3000 cell saving system (Jingjing medical facility corporation, Beijing). Methods Twenty consecutive patients undergoing scheduled off-pump coronary artery bypass grafting (CABG) were divided into two groups according to intraoperative autotransfusion, experimental group(n=10): intraoperative autotransfusion was performed; control group (n=10): intraoperative autotransfusion wasn’t used. Laser diffractometer was used to measure deformation index(DI), small deformation index[(DI)d.max], and orientation index [(DI)or.max],and chromium51 istope labeling technique was used to measure half-life of erythrocytes (51C1/2) of processed and unprocessed in vivo. Results There were no significant difference in DI, (DI)d.max, (DI)or.max and 51C1/2 in vivo between experimental group and control group. Conclusion Intraoperative autotransfusion has no significant effect on erythrocytes’s ability of DI, (DI)d.max, (DI)or.max and 51C1/2 in vivo in off-pump CABG.
Objective To calculate the recovery rate and enrichment factor and to analyse the correlation by measuring the concentrations of platelets, leukocyte, and growth factors in platelet-rich plasma (PRP) so as to evaluate the feasibil ity and stabil ity of a set of PRP preparation. Methods The peripheral blood (40 mL) was collected from 30 volunteers accorded with the inclusion criteria, and then 4 mL PRP was prepared using the package produced by Shandong Weigao Group Medical Polymer Company Limited. Automatic hematology analyzer was used to count the concentrations of platelets and leukocyte in whole blood and PRP. The enrichment factor and recovery rate of platelets or leukocyte were calculated; the platelet and leukocyte concentrations of male and female volunteers were measured, respectively. The concentrations of platelet-derived growth factor (PDGF), transforming growth factor β (TGF-β), and vascular endothel ial growth factor (VEGF) were assayed by ELISA. Results The platelet concentrations of whole blood and PRP were (131.40 ± 29.44) × 109/L and (819.47 ± 136.32) × 109/L, respectively, showing significant difference (t=—27.020, P=0.000). The recovery rate of platelets was 60.85% ± 8.97%, and the enrichment factor was 6.40 ± 1.06. The leukocyte concentrations of whole blood and PRP were (5.57 ± 1.91) × 1012/L and (32.20 ± 10.42) × 1012/L, respectively, showing significant difference (t=—13.780, P=0.000). The recovery rate of leukocyte was 58.30% ± 19.24%, and the enrichment factor was 6.10 ± 1.93. The concentrations of platelets and leukocyte in PRP were positively correlated with the platelet concentration (r=0.652, P=0.000) and leukocyte concentration (r=0.460, P=0.011) in whole blood. The concentrations of platelet and leukocyte in PRP between male and female were not significantly different (P gt; 0.05). The concentrations of PDGF, TGF-β, and VEGF in PRP were (698.15 ± 64.48), (681.36 ± 65.90), and (1 071.55 ± 106.04) ng/ mL,which were (5.67 ± 1.18), (6.99 ± 0.61), and (5.74 ± 0.83) times higher than those in the whole blood, respectively. PDGF concentration (r=0.832, P=0.020), TGF-β concentration (r=0.835, P=0.019), and VEGF concentration (r=0.824, P=0.023) in PRP were positively correlated with platelet concentration of PRP. Conclusion PRP with high concentrations of platelets, white blood cells and growth factors can be prepared stably by this package.