国际麻醉学与复苏杂志   2018, Issue (1): 0-0
    
丙酮酸钠盐水对回收自体血液红细胞功能的影响
李修良, 董鹏, 张晔, 丁冠男, 田鸣1()
1.首都医科大学附属北京友谊医院
Effects of sodium pyruvate solution used in autologous blood recovery on function of salvaged red blood cells
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摘要:

目的 评价丙酮酸钠盐水作为洗涤液应用于自体血液回收对回收红细胞功能的影响。 方法 使用索林自体血液回收机收集和洗涤30例患者的术野回收血液;15例择期行非体外循环冠状动脉旁路移植术的患者设为0.9%氯化钠溶液组(对照组),使用0.9%氯化钠溶液洗涤; 15例择期行膀胱全切术的患者设为丙酮酸钠盐水组(试验组),使用丙酮酸钠盐水洗涤。分别于开始洗涤储血罐中收集的血液时(从患者中心静脉抽血)即刻(T1)、回收红细胞即刻(T2)、回收红细胞21~24 ℃贮存4 h(T3)和回收红细胞1~6 ℃贮存24 h(T4)采集血样,测定两组血样的溶血率、2,3?蛳二磷酸甘油酸(2,3-disphosphoglycerate, 2,3-DPG)、P50值[血氧饱和度(oxygen saturation, SO2)为50%时的氧分压值(oxygen partial pressure, PO2)]及钠离子(Na+)、钾离子(K+)、血乳酸(lactic acid, Lac)、血糖(blood glucose, Glu)水平。 结果 T1时点:两组各指标比较,差异均无统计学意义(P>0.05)。T2、T3和T4时点:溶血率、Glu、2,3?蛳DPG和P50值两组之间比较,差异均无统计学意义(P>0.05),Na+、K+ 和Lac值对照组显著高于试验组(P<0.05)。 结论 丙酮酸钠盐水作为洗涤液对红细胞的洗涤和贮存效果优于0.9%氯化钠溶液,能够改善回收红细胞的质量。

关键词: 丙酮酸钠; 自体血液回收; 红细胞
Abstract:

Objective To assess effects of sodium pyruvate solution used in autologous blood recovery on function of salvaged red blood cells (RBCs). Methods Thirty patients whose blood was autologously recovered and processed using a Dideco Electa device were enrolled.Fifteen patients undergoing elective off-pump coronary artery bypass grafting surgery were assigned to 0.9% sodium chloride solution group (C group), and fifteen patients undergoing elective total cystectomy were assigned to sodium pyruvate solution group (P group). Hemolytic ratio, P50 [the oxygen partial pressure(PO2) corresponding to 50% saturation of the hemoglobin with oxygen], 2,3-disphosphoglycerate(2,3-DPG), sodium(Na+), potassium(K+), lactic acid (Lac) and blood glucose (Glu) of venous RBCs (extracted from the patient's central vein when beginning to wash the collected blood in the reservoir, time T1), salvaged RBCs at 0 h(time T2), salvaged RBCs at 4 h(storage at 21-24 ℃,time T3) and salvaged RBCs at 24 h(storage at 1-6 ℃, time T4) of the two group were measured and compared. Results At time T1, there was no statistically significant difference between all indexes of two groups (P>0.05). At time T2, T3 and T4, there was no statistically significant difference between hemolytic ratio, Glu, 2,3-DPG and P50 value of two groups (P>0.05), but Na+, K+ and Lac value of C group were statistically significant higher than those values of P group (P<0.05). Conclusions The effect of sodium pyruvate solution as washing solution on salvaged RBCs was better than the effect of 0.9% sodium chloride solution.

Key words: Sodium pyruvate; Autologous blood recovery; Red blood cell