心脏外科高危患者的自体献血和输血(作者简介)。

E Dahmen, H Ohlmeier, I Hoppe
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引用次数: 5

摘要

在一组未选择的接受各种心血管手术的患者中,研究了长期术前自体采血联合氧合器血液稀释的可能性。术前平均献血次数为2.5单位血。男性比女性高50%。三分之一的男性患者采集了4-5单位的自体血,与计算出的平均需血量相等,但没有女性患者。这些捐赠的短期或长期不利之处并未被发现。——房间隔缺损患者所需的同种异体血总量可减少50%,房间隔缺损患者甚至可减少70%。无同种异体血患者的比例从占总材料的3%增加到25%,但房间隔缺损患者的比例从13%增加到67%。通过更早地进入自体供体计划,并相应地更早地进行铁替代,可以预期这些值的进一步提高。只有这样,在没有特殊储存方法的情况下,大致计算出一半的心血管手术患者可能没有同种血液。鉴于同种异体输血的风险,目前已经没有房间隔缺损,并且在局限性下,如果没有足够的自体采血,不应该进行瓣膜置换术。
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[Autologous blood donation and transfusion in cardiosurgical high risk patients (author's transl)].

In an unselected group of patients undergoing a wide variety of cardiovascular operations, the possibilities of long-term preoperative autologous blood collection combined with oxygenator hemodilution were examined. The mean number of preoperative donations was 2.5 units of blood. It was 50 p.c. higher in men than in women. One third of the men, but no female patient, collected 4-5 units of autologous blood, thus equalling the mean calculated blood requirements. Short- or long-term disavantages of the donations were not seen. --The total amount of homologous blood required could be diminished by 50 p.c., in atrial septal defects even by 70 p.c. The percentage of patients without homologous blood increased from 3 to 25 p.c. of the total material, but in atrial septal defects from 13 to 67. Further improvements of these values may be expected from an earlier entry into the program of autologous donations and, correspondingly, by an earlier iron substitution. Only thus, without special methods of storage, roughly calculated one half of all cardiovascular surgical patients may come through without homologous blood. In view of the risks of homologous blood transfusion, already now no atrial septal defect and, with limitations, no valve replacement should come to surgery without adequate autologous blood collection.

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