大血管手術（腹部大動脈りゅう手術）における回収式自己血輸血法の検討

Abstract

Intraoperative autotransfusion has proven to be a valuable technique in major vascular surgical procedures in which a large amount of blood loss sometimes occurs.We analysed 45 cases of abdominal aortic aneurysm resection using the autotransfusion system at Mitsui Memorial Hosptal from 1985 to 1988. The patient's age, operating time, amount of intraoperative blood loss, volume of perioperative blood transfusion, occurrence of postoperative complication and changes in the blood coagulating system was compared with 32 cases without this system underwent abdominal aortic resection during 1982 to 1986.There were no specific differences between two groups regarding age, and operating time. However the group without autotransfusion showed higher homologous blood transfusion rate (95.7%) than in the group with autotransfusion (44.7%) (p<0.01). Intraoperative blood transfusion were significantly (p<0.01) lower in autotransfusion group.In the emergency cases, a decrease by autotransfusion was not apparent. One of the key points in the operative techniques is to control the sudden decrease of circulating blood volume when aneurysms are opened.Our method enables the shed blood to retransfuse to the patient directly within about one minute, there is no instablity of circulation.This technique made it possible to succeed in reducing the amount of operative blood loss and the volume of homologus blood transfusion and in increasing the number of non-homologous blood transfusion cases in abdominal aortic aneurysm resection and no coagulation abnormality was found in our method.We concluded that intraoperative autotransfusion technique is useful for the abdominal aortic operation.