目的:探討自體血液回收技術對循環、血細胞和凝血功能的影響及應用效果。方法: 選擇急診大失血手術患者27例,采用ZITI-2000型血液回收機回收血液,經過濾、離心、清洗后回輸給患者。分不同時點觀察HR、SBP、MAP、DBP、SPO2的變化,并監測RBC、Plt、HB、Hct、FIB、PT、APTT的變化。計算輸血量和異體輸血率。隨機選擇8例進行回收原血和回輸 血血細胞學比較。結果:(1)術前血壓較低,心率較快,回輸血液后,HR顯著降低(Plt;0.01),SBP和MAP顯著升高(Plt;0.01)。(2)術前RBC、HB和Hct均低于正常水平,回輸后各時點均升高明顯(Plt;0.01)。術前FIB和Plt低于正常水平,回輸后各時點增高,但無顯著意義。PT、APTT無明顯變化。(3)回收原血平均每例3735mL,回輸血平均每例1589mL,異體輸血率為25％。(4)回輸血RBC、HB和Hct均顯著高于回收原血(Plt;0.01)。結論:自體血液回收技術用于臨床安全可靠,能有效維持循環的穩定,對凝血功能無明顯影響,節約血源,減少異體輸血。
Objective To summarize the recent pathogenetic researches on the acute pancreatitis. Methods Relevant references about the pathogenesis of acute pancreatitis, which were published recently domestic and abroad were collected and reviewed. Results Recent experimental data indicated that the synthesis and release of pro-inflammatory cytokines and chemotactic factors were responsible for local injury and systemic dissemination of the inflammatory mediators. Experimental studies also provided evidences implying that the immune system might play a role in the development of pancreatitis, such as the activation of lymphocyte and neutrophil. Additionally, the pancreas may completely recover or become fibrotic after an attack of acute pancreatitis and the presence of pancreatic stellate cell was known as a crucial factor in the fibrogenesis. Conclusion The pathogenesis of acute pancreatitis is very complicated, the factors that determine the ultimate severity of the attack are still unknown.