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目的:探讨对肠肿瘤患者术中行等容稀释性自体输血(ANH)对患者围术期机体免疫球蛋白的影响。方法:选择肠肿瘤根治术患者30例,随机分为2组。等容稀释性自体输血组(Ⅰ组):于麻醉后手术切皮前经桡动脉放血400ml,同时经静脉输入相当容量的羟乙基淀粉,术中或术后根据情况将患者自身血回输;(Ⅱ组)根据术中情况输异体悬浮红细胞2～3U。分别于术前、术后1、5d抽取静脉血,用单向免疫扩散法测定免疫球蛋白含量。结果:术后1d,IgA、lgG、IgM2组均减少,Ⅰ组术后5d各测定值基本恢复至正常水平,Ⅱ组术后5d仍然低下;IgM2组变化不显著,差异无统计学意义。结论:自体输血对肠肿瘤患者免疫球蛋白影响较小,而异体输血对肠肿瘤患者免疫球蛋白影响明显。围手术期自体输血较异体输血具有明显的优越性。
Objective: To investigate the effect of intraoperative islet dilution autologous blood transfusion (ANH) on the immunoglobulin in perioperative patients in patients with intestinal cancer. Methods: Thirty patients with intestinal tumor were randomly divided into two groups. Isotile dilute autotransfusion group (group Ⅰ): 400ml blood was collected via radial artery before anesthesia, and a considerable volume of hydroxyethyl starch was intravenously administered. Patients’ own blood was transfused intraoperatively or postoperatively ; (Ⅱ group) according to the intraoperative situation of allogeneic suspension of red blood cells 2 ~ 3U. Venous blood was drawn at preoperative and postoperative day 1 and 5, respectively, and the immunoglobulin content was determined by one-way immunodiffusion. Results: The levels of IgA, IgG and IgM2 decreased on the 1st postoperative day in each group, and the values in group Ⅰ recovered to the normal levels on the 5th day after operation. The levels of IgM2 and IgM2 in group Ⅱ remained low at 5 days after operation. The difference was not statistically significant. CONCLUSION: Autologous blood transfusion has little effect on immunoglobulin in patients with intestinal tumor, while allogeneic blood transfusion has obvious effect on immunoglobulin in patients with intestinal tumor. Perioperative autologous blood transfusion than heterologous blood transfusion has obvious advantages.