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1、回输腹腔引流自体血在闭合性脾损伤非手术治疗中应用探究【摘要】目的探讨回输腹腔穿刺引流自体血在闭合性脾损伤非手术治疗中的安全性与可行性。方法对2008年1月至2011年12月安徽省立医院急诊外科94例闭合性脾损伤患者进行综合评估,将其中符合非手术治疗指征并且具有输血指征的44例单纯性脾损伤患者随机(随机数字法)分为治疗组与对照组,观察两组间年龄、性别、创伤评分、损伤分级、腹腔引流血液有核细胞计数、淀粉酶、腹腔引流血液量、输血量及损伤至输血间隔时间有无显著差异,然后治疗组回输腹腔引流自体血,对照组输入异体红细胞,比较两组患者输血前后24h以及治
2、疗后在血液动力学、血液成分及凝血指标等方面的差异。结果两组患者输血后血液动力学指标及贫血指标均显著改善;两组患者输血后各项生理指标变化差异无统计学意义。结论伤情评估及腹腔穿刺引流血检验后,回输腹腔穿刺引流自体血可用于闭合性脾损伤非手术治疗,与输入异体红细胞同样安全有效。【关键词】自体血回输;脾脏闭合性损伤;腹腔穿刺引流;非手术治疗AutologoustransfusionofdrainedbloodfromabdomenforconservativetreatmentofblunttraumaofspleenCAORong-ge,XIAHo
3、ng-hai,CAOBin,LUHua-dong,WANGYing,WEIYan.EmergencyDepartment,AnhuiProvincialHospital,Hefei230001,ChinaCorrespondingAuthor:CAORong-ge,Email:caorongge@126・com[Abstract]ObjectiveTostudythesafetyandfeasibilityofauto-transfusionofblooddrainedfrompatientsownabdomeninpatientswith
4、blunttraumaofspleenasconservativetreatmerit.MethodsFromJanuary1,2008toDecember31,2010,94patientswerediagnosedtobeblunttraumaofspleen・Aftercarefulassessmentandserieslabtests,44patientswereeligibletobenon-operativetreated.Theywererandomly(randomnumber)intotwogroupsinequalnum
5、ber(n二22).Thepatientsofauto-transfusiongroupweretransfusedtheblooddrainedfrompatientsownabdomen,andthecontrolgroupwastransfusedredbloodcellsfromdonors・Thecomparisonofdemographics,ISS(injuryseverityscores),AAST(AmericanAssociationfortheSurgeryofTrauma)andlabfindingsbetweent
6、wogroupsbeforeandaftertransfusionwithttestandchi-squaretest・Thenpaired-samplesttestwasusedtoanalyzethehemodynamics,bloodcomponentsandbloodclottingindexesoftwogroupsbeforeandafterbloodtransfusion.Meanwhilettestwasdoneaswelltocomparethedifferencesintheabovevariablesbetweentw
7、ogroupsaftertransfusion.SPSS10.0versionwasusedtoanalyzethecollecteddata・ResultsTherewerenosignificantdifferencesindemographicsandphysicalconditionbetweentwogroups・Afterbloodtransfusion,thehemodynamicsandanemiaoftwogroupsweresignificantlyimproved,andtherewerenodifferencesin
8、thechangesoftheabovevariablesbetweentwogroups・ConclusionsBlooddrainedfrompatientownabdome