The goal of this single-center prospective randomized controlled trial is to test and compare the safety and effectiveness of autologous blood transfusion in spinal surgery for lung cancer spinal metastases. The main questions it aims to answer are:
* Does autologous blood transfusion increase the incidence of new metastases? * Does autologous blood transfusion affect postoperative hemoglobin levels and the number of circulating tumor cells in the blood? * Can autologous blood transfusion reduce the rate of allogeneic transfusion during and after surgery for spinal metastases?
The age range is 18-75 years old;
The pathological diagnosis was lung cancer and spinal metastatic tumor;
Expected survival > 3 months, can tolerate surgery;
Unstable spine; And/or spinal cord nerve compression, nerve function; Progressive decline, palliative spinal open decompression surgery
Serious heart dysfunction or heart failure, diagnosed blood system diseases, coagulation disorders;
Severe renal insufficiency or need hemodialysis treatment;
Sepsis or septicemia;
Unable to obtain consent from the patient or family.
Parallel
Autoblood transfusion
Procedure/SurgeryThrough a negative pressure suction device, the patient's blood that flows out during surgery is collected into a blood storage filter. During the suction process, it is mixed with an appropriate anticoagulant and passed through multiple layers of filters. When the volume of recovered blood reaches a certain level, it is continuously (or intermittently) centrifuged. Using a high-speed centrifugal blood recovery tank, the red blood cells are separated, and the plasma, waste, cell fragments, anticoagulants, and harmful components are diverted into a waste bag. A large amount of saline is used to repeatedly wash, purify, and concentrate the red blood cells. Finally, the concentrated red blood cells are prepared into a 70% red blood cell suspension with saline and stored in a collection bag for transfusion back to the patients. Open surgery is considered as the standard procedure for metastatic spinal cord compression
Intraoperative and postoperative allogeneic blood transfusion rate
The number of allogeneic blood transfusion patients (Intraoperative or postoperative )/ the total number of patients
Number of circulating tumor cells in the blood
Number of circulating tumor cells in the blood
Incidence of transfusion related adverse reactions
the number of adverse reactions/ the total number of patients
occurence of new lesions
the number of patients with occurence of new lesions / the total number of patients
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