急性等容性血液稀释联合自体血回输对心脏瓣膜置换术患者血气指标凝血功能及输血并发症的影响

doi:10.3969/j.issn.1006-6233.2021.02.025

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Abstract Objective: To explore the effect of acute isovolumetric hemodilution (ANH) combined with autologous blood transfusion on blood gas indexes, coagulation function and blood transfusion complications in patients undergoing heart valve replacement surgery. Methods: 102 patients who underwent heart valve replacement in Panzhihua Central Hospital from January 2018 to January 2019 were selected as the research objects. The simple random number table method was randomly divided into observation group and control group, with 51 cases in each group. The patients in the control group were transfused with untreated remaining bank blood or machine blood, and the patients in the observation group were transfused with ANH combined with autologous blood. Before blood dilution, 15min, 24h, 48h after the end of the operation, record the blood gas index and coagulation function index at each time period, and record the operation time, intraoperative blood loss, chest drainage volume, fluid replacement volume, allogeneic blood transfusion volume, hospitalization Time and complications of blood transfusion within 1 day after operation. Results: There was no statistically significant difference in the operation time, intraoperative blood loss, fluid supplementation, and hospital stay between the two groups of patients (P>0.05). The observation group had significantly less chest drainage and allogeneic blood transfusion. In the control group, the difference was statistically significant (P<0.05). The PvO₂, PvCO₂, and Fib levels of the two groups of patients decreased first and then increased, while the levels of PT, APTT, and TT increased first and then decreased. The differences between the time points within the group were statistically significant (P<0.05). Except before hemodilution, the differences between the groups at each time point were statistically significant (P<0.05); there were no statistically significant differences in the pH levels of the two groups at each time point in the group or between the time points. (P>0.05). The incidence of blood transfusion complications in the observation group was lower than that in the control group, but the difference between the groups was not statistically significant (P>0.05). Conclusion:Acute isovolumetric hemodilution combined with autologous blood reinfusion has little effect on blood gas indicators and coagulation function in patients undergoing heart valve replacement surgery. It can significantly reduce the volume of foreign blood transfusion and adverse blood transfusion reactions. The combination of the two can protect blood more effectively. It is a safe and effective way of blood transfusion.

Key words： Acute normovolemic hemodilution Autologous blood transfusion Heart valve replacement surgery Blood gas analysis Coagulation function Blood transfusion complication

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	ZHANG Bangjian
	LIU Yixin
	HAN Qingtao
	et al

Cite this article:

ZHANG Bangjian,LIU Yixin,HAN Qingtao, et al. Effects of Acute Normovolemic Hemodilution Combined with Autologous Blood Transfusion on Blood Gas Index Coagulation Function and Transfusion Complications in Patients Undergoing Cardiac Valve Replacement[J]. HeBei Med, 2021, 27(2): 292-297.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.02.025 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I2/292

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