[原著］心臓大血管手術における自己血貯血の検討

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We evaluated 208 autologous blood donors undergoing elective cardiovascular surgery during the period between August 1999 and August 2001. Subjects were 150 men and 58 women aged from 11 to 83 years with a mean of 60 years. All patients were administrated subcutaneous recombinant human erythropoietin with oral iron sulfate, and the total collected blood volume per patient ranged from 200 to 2800ml with a mean of 1229ml during $14 \pm 3$ days. Operative procedures included solitary coronary artery bypass grafting in 67 patients, solitary valve replacement in 51, thoracic aortic graft replacement in 35, abdominal aortic graft replacement in 23, cardiac anomaly repairs in 11 and others in 21. Of these 208 patients, 154 (74%) did not require any homologous blood transfusions in hospital stay, but the number of the patients without homologous blood transfusion were 18 (51.4%) in the 35 thoracic aortic graft replacements. This avoidance rate of homologous blood transfusion was significantly lower than those of other operative method ( p<0.04), though the thoracic aortic group had siginificantly higher volume ($1473 \pm 596$ml) of collected autologous blood than other operative groups ( p< 0.02). This low rate was caused by the more extended operation resulting in the higher volume of surgical blood loss. The other predictors for homologous blood use were anemia, age and reoperation. We thought that the positive preoperative blood donation during the proper preoperative period according to the expected operative procedure and continuous challenge to limits of surgical blood loss are important factor for reducing operative or postoperative homologous blood requirements.
琉球医学会,Ryukyu Medical Associationの論文

[原著］心臓大血管手術における自己血貯血の検討

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