本文選題：血液回收 + 紅細(xì)胞��； 參考：《遵義醫(yī)學(xué)院》2015年碩士論文

【摘要】：目的:觀察手術(shù)患者回收紅細(xì)胞在體內(nèi)的消亡情況。方法:隨機(jī)選擇51例擇期行骨科手術(shù)患者(n=51),分為血液回收組(I組,n=27)和對(duì)照組(C組,n=24)。兩組均分別于術(shù)前、術(shù)后、術(shù)后24h,48h,72h,96h取靜脈血測(cè)紅細(xì)胞計(jì)數(shù)、血紅蛋白含量、游離血紅蛋白并記錄術(shù)中失血量和尿量和術(shù)后24h,48h,72h的引流量。并于術(shù)前、術(shù)后、術(shù)后24h,48h,72h取靜脈血1ml經(jīng)裂解紅細(xì)胞、CD14 antibody閉光孵育、Cytofix/CytopermTM Plus Fixation/Permeabilization Kit破膜固定、CD235a室溫孵育之后流式細(xì)胞儀檢測(cè)單核細(xì)胞、中性粒細(xì)胞吞噬紅細(xì)胞的數(shù)量。結(jié)果:兩組患者術(shù)前一般資料無統(tǒng)計(jì)學(xué)差異。術(shù)中I組失血量明顯高于對(duì)照組,但術(shù)后當(dāng)天兩組患者紅細(xì)胞計(jì)數(shù)、血紅蛋白含量、游離血紅蛋白均無明顯差異。術(shù)后1-3天兩組引流量和液體出入量也無明顯差異,I組紅細(xì)胞計(jì)數(shù)降低、血紅蛋白濃度下降的患者數(shù)明顯高于C組,且I組患者術(shù)中血液回收量與術(shù)后血紅蛋白最低點(diǎn)呈顯著負(fù)相關(guān)(p=0.005)。而兩組游離血紅蛋白濃度則無明顯差異。不論是總的吞噬量還是中性粒細(xì)胞的吞噬量,在術(shù)后2、3天時(shí),I組都明顯高與C組(p0.05)。結(jié)論:血液回收在術(shù)中能較好地發(fā)揮血液保護(hù)的作用,減少異體血需要量:但回收紅細(xì)胞可能在術(shù)后2-3天內(nèi)迅速死亡;回收紅細(xì)胞的死亡不是血管內(nèi)破裂而是被單核巨噬細(xì)胞系統(tǒng)吞噬。
[Abstract]:Objective: to observe the death of recovered red blood cells (RBC) in patients undergoing surgery. Methods: Fifty-one patients undergoing elective orthopedic surgery were randomly divided into two groups: blood recovery group (group I) and control group (group C). The red blood cell count, hemoglobin content, free hemoglobin and blood loss during operation and urine volume were recorded in both groups before operation and 24 hours after operation, 48 hours after operation and 72 hours after operation, and 72 hours after operation. Before operation, 24 hours after operation, 48 hours and 72 hours after operation, the venous blood 1ml was incubated with CD14 antibody of the lysed red blood cells. After incubating with Cytofix-CytopermTM Plus Fixation / Permeabilization Kit fixed at room temperature, CD235a, the number of monocytes and neutrophils phagocytosis of erythrocytes was measured by flow cytometry. Results: there was no significant difference in preoperative general data between the two groups. The amount of blood loss in group I was significantly higher than that in control group, but there was no significant difference in erythrocyte count, hemoglobin content and free hemoglobin between the two groups on the day of operation. At 1-3 days after operation, there was no significant difference between the two groups in the volume of drainage and the volume of fluid in group I. The number of patients with decreased hemoglobin concentration in group I was significantly higher than that in group C. In group I, there was a significant negative correlation between the volume of blood recovered during operation and the lowest level of hemoglobin after operation (p0. 005). There was no significant difference in free hemoglobin concentration between the two groups. Both the total phagocytosis and the phagocytosis of neutrophilic granulocytes were significantly higher in group I than those in group C (p0.05) 2 days after operation. Conclusion: blood recovery can play a better role in blood protection and reduce the requirement of allogeneic blood. But the recovered red blood cells may die quickly within 2-3 days after operation. The death of the recovered red blood cell is not an intravascular rupture but swallowed by a mononuclear macrophage system.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R614

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相關(guān)期刊論文 前3條

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本文編號(hào)：2076728