Clinical Study On The Blood Conservation Effect Of Different Autotransfusion Methods In Open Spinal Surgery

Objective: To investigate the safety and effective response of different autologous blood transfusions in open spinal surgery.Methods: Sixty-two patients,32 males and 30 females,aged 21～71 years,ASA physical status Ⅰ or Ⅱ,scheduled undergoing Open pedicle fixation and interbody fusion under general anesthesia,were randomly allocated to three groups:Acute normovolemic hemodilution(group A,n=20),Intraoperative blood salvage(group B.n=22),neither acute normovolemic hemodilution nor Intraoperative blood salvage(group C,n=20).In group A,the blood of the patient’s own were collected before surgical operation and after anesthesia,and the equivalent volume of colloidal fluid was infused at the same time.In group B,the blood recovery machine(Jingjing 3000P)was used to recover the field hemorrhage.All three groups were anesthetized in the same way.The intraoperative blood loss,drainage volume,perioperative bleeding,Autogenous blood transfusion,Perioperative allograft blood transfusion,preoperative and postoperative Hb,Hct values were recorded for comparative analysis.Result: Compared with group C,there was no statistically significant difference in intraoperative blood loss in group A(P>0.05),but the postoperative drainage volume and perioperative bleeding volume were reduced(P<0.01)?Between group B and C,there was no statistically significant difference in intraoperative blood loss(P>0.05),but the postoperative drainage volume and perioperative blood loss increased in group B(P<0.01).Postoperative Hb and Hct values were higher in group A than C(P<0.01)and there was no statistically significant difference between group B and C(P>0.05).When the perioperative blood loss <2000ml,the perioperative allogeneic red blood cell input and rates of group A was lower than that of group C(P<0.05),and the free transfusion rate of foreign blood(RBC and FFP)in group A was higher(P <0.05).There was no difference between group B and C(P>0.05).When the perioperative blood loss≥2000ml,all three groups require allogeneic blood transfusion and there was no statistically significant difference in volume and rate(P>0.05).At different levels of hemorrhage,no one needed to transfusion plasma in group A.In group A,16 patients(80%)did not receive homologous blood,the Group B was 7 patients(31.8%)and the Group C was 3 patients(15%).The no-transfusion rate of group A and group C was significantly different(P<0.05),while the difference between group B and group C was not statistically significant(P>0.05).Conclusion:Acute normovolemic hemodilution has a significant effect on blood protection in open spinal surgery and can effectively reduce the input of allogenic blood.