儿童脊柱侧凸中细胞保存器处理血液的评价

Elena García, P. Rey, E. Martínez
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引用次数: 2

摘要

简介:我们研究了自体血液的血液学和微生物学特征,这些血液是通过我们中心在小儿脊柱侧凸矫正手术中使用的术中细胞保存器(Orthopat®)处理的,这是一种已知的潜在出血手术。材料与方法:对31例小儿脊柱侧凸手术患者进行描述性分析。所有患者术中均接受细胞保存器处理过的血液。收集的变量包括:人口统计学数据、自体红细胞(RBC)浓缩物体积、血细胞计数、生物化学、血培养、患者术前和术后血液检查、红细胞浓缩物回输期间发热发生率、术后手术部位感染和住院时间。结果:平均体积288.06ml (sd 154.68)。红细胞压积70.38% (sd 10.03),符合cell-saver商业数据(75%)。在采集的血液样本中,需氧菌血培养阳性率为42.86%,厌氧菌血培养阳性率为48.28%。术后感染与血浓缩物污染的关系无统计学意义。术前与术后分析标本比较,有统计学差异(p <0.05)的有:术后血红蛋白、红细胞压积下降,凝血参数有凝血功能障碍倾向。结论:我们的细胞保存器获得红细胞浓缩物,其红细胞压积百分比与现有信息一致。从感染和生化的角度来看,它们的回输是安全的,但其免疫学意义尚不清楚。这个手术继续导致大量失血。为避免同种异体输血而采取的措施仍然是必要的,并应予以加强。
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EVALUATION OF BLOOD PROCESSED BY CELL SAVER IN PEDIATRIC SCOLIOSIS
Introduction:We study the hematological and microbiological characteristics from the autologous blood processed through the intraoperative cell saver used in our centre (Orthopat®) during the correction of pediatric scoliosis, which is known to be a potentially bleeding surgery. Material and methods: Descriptive analysis of 31 patients undergoing pediatric scoliosis surgery. All of them received blood processed by cell saver intraoperatively. The variables collected were: demographic data, volume of the autogenous red blood cell (RBC) concentrate, blood count, biochemistry, blood culture, preoperative and postoperative blood tests of the patients, incidence of fever during reinfusion of RBC concentrate, postoperative surgical site infections and length of hospital stay. Results: Average volume obtained 288.06ml (sd 154.68). Hematocrit 70.38% (sd 10.03) in accordance with cell-saver commercial data (75%). Of the blood samples obtained, 42.86%  had blood cultures that were positive for aerobes and 48.28% for anaerobes. The relation between postoperative infections and contamination of blood concentrates was not statistically significant. When comparing the pre-surgery and post-surgery analytical samples, statistically significant differences (p <0.05) were found in the following: hemoglobin and hematocrit decreased in the postoperative period, while coagulation parameters show a tendency to coagulopathy. Conclusion: Our cell saver obtains RBC concentrates with a percentage of hematocrit in agreement with available information. The reinfusion of them is safe from an infectious and biochemical point of view, but its immunological implications are not clear. This surgery continues to result in a significant loss of blood. Measures taken to avoid allogenic transfusions remain necessary and should be enhanced.
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