本文選題：門脈高壓 + 自體血回輸　； 參考：《吉林大學(xué)》2015年碩士論文

【摘要】：目的： 探究肝炎后門脈高壓癥患者脾切斷流術(shù)中應(yīng)用回收式自體血回輸其對肝炎病毒載量的影響，以及病毒載量的改變率與回輸血量的相關(guān)性。 方法： 收集吉林大學(xué)第一醫(yī)院肝膽胰外科2014年7月至2015年3月收治的15例乙型肝炎后肝硬化門靜脈高壓癥行脾切斷流術(shù)并于術(shù)中應(yīng)用回收式自體血回輸?shù)幕颊叩呐R床資料，采用PCR酶聯(lián)化學(xué)發(fā)光法測定患者術(shù)前及術(shù)后3天的HBV DNA定量，常規(guī)檢測術(shù)前及術(shù)后1天晨起外周血血紅蛋白值，，計算術(shù)前、術(shù)后病毒載量的改變率，并利用SPSS19.0軟件進行數(shù)據(jù)統(tǒng)計學(xué)分析。 結(jié)果： ①15例患者術(shù)中回收式自體血回輸后均未出現(xiàn)溶血反應(yīng)、發(fā)熱反應(yīng)。 ②15患者術(shù)前、術(shù)后外周血血紅蛋白值分別為（104.24.5）g/L和（113.93.7）g/L，術(shù)后較術(shù)前明顯升高且存在顯著性差異（P=0＜0.05）。 ③15患者術(shù)前、術(shù)后HBV DNA定量分別為（277252.4147254.2）IU/ml和（211063.1133620.4）IU/ml，術(shù)前、術(shù)后HBV DNA無顯著性差異（P=0.435＞0.05）。 ④15例患者術(shù)前、術(shù)后HBV DNA改變率與回輸血量不相關(guān)，其pearson相關(guān)系數(shù)為-0.713。 結(jié)論： 肝炎后門脈高壓癥患者脾切斷流術(shù)中應(yīng)用回收式自體血回輸技術(shù)安全有效，可明顯提高患者術(shù)后的血紅蛋白值水平從而減少血制品的用量。術(shù)中應(yīng)用回收式自體血回輸對其病毒載量無明顯影響，且病毒定量的改變率與回輸血量不相關(guān)，但仍需要大樣本的隨機化前瞻性研究證據(jù)支持，同時需要對照實驗排除脾臟血的影響。
[Abstract]:Objective:
To explore the effect of reclaimed autologous blood transfusion on the load of hepatitis virus, and the correlation between the rate of change of viral load and the amount of blood transfusion during the splenectomy for patients with posterior portal hypertension of hepatitis.
Method:
The clinical data of 15 patients with portal hypertension in the liver and cirrhosis of the liver treated in the No.1 Hospital of Jilin University from July 2014 to March 2015 were collected and the clinical data of reclaimed autologous blood transfusion were used in the operation. The PCR chemiluminescence method was used to determine the HBV DNA quantity before and 3 days after the operation. The hemoglobin values of peripheral blood before and 1 days after operation were measured before and after operation. The change rate of viral load before and after operation was calculated and statistically analyzed by SPSS19.0 software.
Result:
There was no hemolytic reaction and fever reaction in 15 patients after the recovery of autologous blood transfusion.
(15) before operation, the hemoglobin value of peripheral blood was (104.24.5) g/L and (113.93.7) g/L after operation, and there was significant difference after operation (P=0 < 0.05).
(3) before operation, the HBV DNA was (277252.4147254.2) IU/ml and (211063.1133620.4) IU/ml after operation, and there was no significant difference between HBV DNA before and after operation (P=0.435 > 0.05).
(4) there was no correlation between the change of HBV DNA and the amount of blood transfusion in 15 patients before and after operation, and the correlation coefficient of Pearson was -0.713.
Conclusion:
The recovery of autologous blood transfusion is safe and effective in the operation of the splenectomy for the patients with posterior portal hypertension, which can obviously improve the hemoglobin level of the patients and reduce the amount of blood products. The use of the reclaimed autologous blood transfusion during the operation has no obvious effect on the viral load, and the rate of change of the virus quantitative and the amount of the blood transfusion is not similar. However, large sample randomized trial is needed to support the evidence. Meanwhile, a controlled experiment is needed to exclude the effects of splenic blood.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R657.34

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