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目的:探讨术中自体血回输对多发伤损伤控制性手术患者肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、c-反应蛋白(CRP)的影响。方法:选择我院2015-05-2016-01收治的多发伤损伤控制性手术患者30例,随机分为自体血回输组(IAT组)和异体血输注组(ABT组)2组,于麻醉诱导前、术后第1天、术后第3天用肝素抗凝试管采集空腹静脉血,ELISA方法检测血清中CRP、IL-6和TNF-α的表达水平。结果:2组患者在年龄、性别、术中出血量、术前血红蛋白量、术中输血量及受伤类型等比较差异无统计学意义,2组患者在输血第1天、第3天(T1、T2)TNF-α、IL-6较麻醉诱导前(T0)显著升高(P<0.05),CRP到T2时才显著升高(P<0.05);IAT组TNF-α、IL-6在T1、T2时显著低于ABT组(P<0.05),而2组CRP差异无统计学意义。结论:自体血回输能够降低多发伤损伤控制性手术患者TNF-α、IL-6炎症水平,对输血安全和临床治疗有重要意义。
Objective: To investigate the effect of intraoperative autologous blood transfusion on tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and c-reactive protein (CRP) in patients with multiple traumatic injury controlled surgery. Methods: Thirty patients with controlled traumatic multiple injuries treated in our hospital from May 2015 to May 2016 were randomly divided into 2 groups: autologous blood transfusion group (IAT group) and allogeneic blood transfusion group (ABT group) Fasting venous blood was collected on the first day after operation and on the third day after operation, and the levels of CRP, IL-6 and TNF-α in the serum were detected by ELISA. Results: There was no significant difference in age, sex, blood loss, blood volume of hemoglobin, volume of blood transfusion and type of injury between the two groups. On the first day and the third day after blood transfusion, (P <0.05). The levels of TNF-α and IL-6 in T2DM group were significantly higher than those in TAT group (P <0.05) , Significantly lower than that of the ABT group at T2 (P <0.05), while there was no significant difference between the two groups. CONCLUSIONS: Autologous blood transfusion can reduce the levels of TNF-α and IL-6 in patients with multiple traumatic injury control surgery, which is of great significance for the safety and clinical treatment of transfusion.