The effect of washing autotransfusion salvage on thromboelastography and immune function in patients undergoing knee and hip arthroplasty surgery
Chen Jinfan1, Zha Chengxi1, Guo Xingxing1, Wang Lijuan1, Yang Jianzhong1, Chen Yuan1, Lan Jiongcai2
1Department of the Blood Transfusion, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730050, China;2Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
Abstract:ObjectiveTo explore the effect of washing autotransfusion salvage on thromboelastography and immune function of patients undergoing knee and hip arthroplasty surgery. MethodsA total of 186 patients with 400-1000ml bleeding and 400-600ml of recovered blood transfusion during knee and hip arthroplasty surgery who were admitted to the Orthopedics Department of Gansu Provincial Hospital of Traditional Chinese Medicine from January to December 2019 were selected as the observation group, and at the same time 162 patients with allogeneic transfusion were selected as the control group. The postoperative hemoglobin (Hb), red blood cell count (RBC), hematocrit (HCT), thromboelastography, including reaction time (R), maximum amplitude (MA), blood clot formation time (K), α and cellular immune function (including CD3+CD4+T cells, CD3+CD8+T cells, CD16+CD56+NK cells) levels of the two groups of patients before and 1d, 5d after blood transfusion were tested and compared. ResultsOne day after blood transfusion, Hb (112.57±14.32)g/L, HCT (34.10±3.32)%, RBC (3.12±0.53)×1012/L, PLT (125±31)×109/L of the observation group were compared with those of the control group [Hb (108.35±12.84)g/L, HCT (33.52±3.04)%, RBC (2.91±0.42)×1012/L, PLT (123±40)×109/L], the differences were not statistically significant (t=0.36, 1.21, 1.37, 1.94, all P>0.05). Five days after blood transfusion, Hb, HCT, RBC, PLT [(122.52±13.70)g/L, (40.12±3.80)%, (3.91±0.45)×1012/L, (135±39)×109/L] levels of the observation group were compared with those of the control group [Hb (118.31±13.91)g/L, HCT (35.50±3.70)%, RBC (3.14±0.61)×1012/L, PLT (127±31)×109/L], the differences were statistically significant (t=7.01, 5.58, 5.72, 7.61, all P<0.05). One day after blood transfusion, the R, MA, K, α [(5.97±0.31)min, (56.73±2.24)mm, (2.57±0.10)mm, (59.88±1.73)°] of the observation group were compared with those in the control group [R (6.07±0.30)min, MA (57.68±1.78)mm, K (2.70±0.52)min, α (61.12±3.09)°], showing no statistically significant differences (t=2.02, 0.90, 0.66, 0.99, all P>0.05). Five days after blood transfusion, the R, MA, K, α [(6.62±0.59)min, (63.81±0.86)mm, (2.95±0.19)min, (61.12±2.36)°] of the observation group were compared with those of the control group [R (6.82±1.21)min, MA (62.99±1.88)min, K (2.82±0.18)min, α (60.50±2.07)°], showing no statistically significant differences (t=1.70, 1.04, 1.33, 0.56, all P>0.05). Flow cytometry analysis showed that 1 day after blood transfusion, the level of CD3+CD4+T cells in the observation group (33.66±2.10) was significantly higher than that in the control group (29.88±1.97) , the difference was statistically significant (t=3.72, P<0.01). Five days after blood transfusion, the levels of CD3+CD4+T cells (35.92±0.79), CD3+CD8+T cells (21.82±1.61), and CD16+CD56+NK cells (1.68±0.14) of the observation group were significantly higher than those of the control group (29.83±2.11, 20.53±2.71, 1.03±0.13), the differences were statistically significant (t=7.66, 6.57, 9.58, all P<0.01). ConclusionCompared with allogeneic transfusion, washing autotransfusion salvage does not affect the R, MA, K, α of thromboelastography of patients undergoing knee and hip arthroplasty surgery, and could improve the patient′s cellular immune function.
陈进凡1查成喜1郭星星1汪丽娟1杨建忠1陈瑗1兰炯采2. 洗涤回收式自体输血对膝关节、髋关节置换术患者血栓弹力图及免疫功能的影响[J]. 中华诊断学电子杂志, 2022, 10(1): 53-58.
Chen Jinfan1, Zha Chengxi1, Guo Xingxing1, Wang Lijuan1, Yang Jianzhong1, Chen Yuan1, Lan Jiongcai2. The effect of washing autotransfusion salvage on thromboelastography and immune function in patients undergoing knee and hip arthroplasty surgery. zhzdx, 2022, 10(1): 53-58.