【摘要】 目的比较脊柱手术中患者回收血与库存血的红细胞流变学特性。方法择期行腰椎管减压联合椎弓根内固定术的患者30例,年龄44～80岁,ASAⅡ或Ⅲ级,使用自体-2000型血液回收机行术中自体血回收,取经血液回收机回收处理后的回收血；另取分属不同献血者的库存9～15d去白细胞浓缩红细胞悬液30份。用激光衍射法测定红细胞在高粘场中的最大变形指数(DI_max)、积分变形指数（IDI）及在低粘场中的最大小变形指数[（DI）_d,max]和最大取向指数[（DI）_or,max]；采用荧光偏振法测定红细胞膜的荧光强度,并计算荧光偏振度（p）及表征细胞膜流动性的微粘度（η）；测定不同浓度NaCl溶液中加入红细胞后上清液的透光率,计算红细胞溶血率,并绘制渗透脆性曲线。结果与库存血比较,回收血（DI）_or,max升高,在NaCl浓度为0.20%～0.75%时红细胞溶血率低（P＜0.05）,DI_max、IDI、（DI）_d,max、p和η差异均无统计学意义（P＞0.05）；回收血红细胞渗透脆性曲线较库存血左移。结论回收血红细胞流变学特性优于库存血。更多还原

【Abstract】 Objective To compare the theology properties of RBCs of shed blood salvaged from operative field and the stored concentrated RBCs.Methods Thirty ASAⅡorⅢpatients aged 40-80 yrs undergoing elective spinal canal decompression procedure were enrolled in this study.ZITI-2000 cell saver system was used for intraoperative blood salvage.The concentrated RBCs had been stored for 9-15 days in blood bank.The maximal deformation index(DI_max)and integral deformation index（IDI）in hyperviscous medium and the maximal small deformation index[（DI）_d,max]and maximal orientation index[（DI）_or,max]in low viscous medium were measured with laser diffractometer.The fluorescence intensity of erythrocyte membrane was determined by fluorescence polarization technique and the fluorescence polarization（p）and micro-consistency（η）which stands for erythrocyte membrane fluidity were calculated.RBCs were added to different concentrations of NaCl solution.The transmittance of supernatant was determined and the rate of hemolysis was calculated.The osmotic fragility curves were obtained.Results There were no significant differences in DI_max,IDI,（DI）_d,max,p andηbetween the two groups.The（DI）_or,max of the salvaged RBCs was significantly higher than that of stored RBCs（P＜0.05）.The rate of hemolysis of stored RBCs was significantly higher than that of salvaged RBCs（P＜0.05）in th NaCl solution.The osmotic fragility curve of salvaged RBCs was shifted to the left as compared with that of stored RBCs.Conclusion The rheology property of salvaged RBCs is better than that of stored RBCs.更多还原