| Objective and methods:To investigate the effects on the red cell retrieval rate of the intraopertive blood salvage by ligustrazine and the changes in blood coagulation after reinfusion the selfblood, on the basis of which to evaluate the security of retrieval rate of red cell and blood coagulation by ligustrazine. Eighty ASA I - II patients undergoing elective lumbar surgery were randomly allocated to 0.05mg/ml ligustrazine autotransfusion group (group A),0.1mg/ml ligustrazine autotransfusion group (group B),0.2mg/ml ligustrazine autotransfusion group (group C) or autotransfusion group (control group). The patients without any blood and endocrine system diseases evaluated bleeding over 500ml were selected for the investigation before surgery. In group A,B and C, ligustrazine with the dose of 4mg/kg had been injected intravenously to the patients 30min before their blood was collected. And ligustrazine was respectively put into the washing saline and heparinized saline solution up to the concentration of 0.05mg/ml,0.1mg/ml and 0.2mg/ml. Shed blood of four groups were collected and heparinized with the same autotransfusion device (Medtronic autolog). The red cells were filtrated, separated and washed before reinfusion to the patients. Then red blood cell (RBC), hemoglobin (HB), hematocrit (HCT) of the salvaged blood samples were measured before reinfusion. The retrieval rate of red cell was calculated according to formula. HB, HCT, platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT) and plasma fibrinogen concentration (FIB) of the samples were determined, which were collected in such phases as before operation, after blood transfusion and 24h after operation, respectively. The related parameter of thromboelastography (TEG) was counted before operation and after reinfusion, at the same time, the volume of shed blood 24h after operation was also taken down. As the negative control, no ligustrazine was put into the washing saline and heparinized saline, at the same time, no ligustrazine was injected to the patients.Results:There was no difference on age, sex, blood loss, the volume of reinfusion and shed blood 24h after operation among the four groups. In groupA,B and C, RBC, HB, HCT of the salvaged red cell concentrate was significantly higher than the control group after filtrating, separating and washing by the autotransfusion device. And the retrieval rate of red cell was markedly higher than the control group. Ligustrazine at higher concentration trend to increase the retrieval rate of red cell. In all groups HB, HCT and PLT decreased significantly after reinfusion and 24h after operation by contrast with preoperation. PT and APTT of all groups prolonged significantly after reinfusion. Compared with the control group, there was difference in APTT of groupB and C .In group B and C, PT and APTT 24h after operation was significantly longer than preoperation, but there was no significant difference among the four groups. In all groups, FIB concentration decreased significantly after reinfusion and recovered to the normal conditions after 24h of operations. TEG showed that reaction time (R) and coagulation time (K) increased significantly after reinfusion, on the contrary angleαand maxium amlitude(MA) decreased. But there was no significant difference among the four groups.Conclusion:Ligustrazine had protective effects on red cells during intraoperative blood salvage, it can significantly increase the retrieval rate of red cell and reduce the requirement of homologous blood perioperation. Ligustrazine at higher concentration trend to increase the retrieval rate of red cell. And ligustrazine at concentrations of 0.1mg/ml and 0.2mg/ml enhance the inhibition of blood coagulation. In order to avoid the impediment in coagulation, coagulation parameters must be monitored, especially when the loss of blood was mass. |
PDF Full Text Request