贮存式自体血回输对产妇分娩后E2、P、PRL的影响  

The effect of preoperative autologous blood retransfusion postpartum on levels of estrogen,progesterone and prolactin

作　　者：丁杰锋[1] 华凯[1] 陈海江[1] 杨迪琼[1] 王利娥[1] 赵俐[1] 

机构地区：[1]绍兴市妇幼保健院,浙江绍兴312000

出　　处：《中国输血杂志》2014年第11期1166-1169,共4页Chinese Journal of Blood Transfusion

基　　金：绍兴市科技局重点资助课题(2010A23013)

摘　　要：目的研究贮存式自体血回输对产妇雌孕激素影响,探讨产妇贮存式自体输血的可行性。方法首先分析不同分娩方式产后48 h E2、P、PRL浓度变化规律,然后采用对队列照研究,对不同分娩方式的产妇进行自体血回输和未进行自体血回输,产前与产后48 h E2、P、PRL、Hb浓度变化;同时,对剖宫产自体输血产妇,未输血,术中输血与术后24 h输血的3种激素比较E2、P、PRL3种激素浓度,分析不同时机自体血回输对产后48 h时激素浓度的影响。结果平产与剖宫产对照组产后48 h血液中E2、P浓度采用两独立标本t检验2组间无统计学意义(P>0.05),但剖宫产产后48 h的PRL浓度显著低于平产组(t=3.022,P<0.05);平产产妇自体血回输对产后激素无明显影响;剖宫产产妇自体血回输血产后48 h的PRL浓度显著提升(F=6.71,P<0.05),剖宫产产妇术后回输在产后48h E2浓度显著高于术中回输组与未输血组。结论在剖宫产产妇中,自体血回输有助于产妇PRL水平的提升。剖宫产术后自体血回输血,会出现E2浓度一段时间内升高,并且下降速度放缓。Objective To study the feasibility of PABD retransfusion and its impact on levels of maternal hormones.Methods First,the serum levels of estrogen（ E2）,progesterone（ P） and prolactin（ PRL） of different modes of delivery at48 hours postpartum stage were analyzed. Then,using cohort study,a comparison was conducted on the levels of E2,P,PRL and hemoglobin（ Hb） of different modes of delivery before or during PABD,prepartum or 48 hours postpartum. Meanwhile,to analyze whether transfusing at different time would influence the hormonal levels after Cesarean delivery,the levels of E2,P and PRL 48 h postpartum were compared among the patients who received PABD during operation,the patients who received PABD 24 h after Cesarean and those in the control group. Results There were no significant difference in the levels of E2 and P at the 48 h postpartum stage in both vaginal delivery group and cesarean group,using independent two- sample t- test（ P 0. 05）,but the level of PRL in the vaginal delivery group 48 h postpartum was significantly lower than that of cesarean group（ P 0. 05,t = 3. 022）. No statistical difference was found when comparing the hormonal levels in vaginal delivery patients who either received PABD or non- PABD. Among the cesarean patients,the level of PRL was significantly higher in PABD group than that in patients without PABD（ F = 6. 71,P 0. 05）. The level of E2 in patients receiving PABD after cesarean was significantly higher than that of patients receiving PABD during operation and that in the control group. Conclusion In cesarean patients,PABD could help to promote the level of PRL at postpartum stage. When patients retransfuse after Cesarean delivery,a temporary increase of E2 was noted,followed by a slow descent.

关 键 词：贮存式 自体血 产妇 分娩 

分 类 号：R457.1[医药卫生—治疗学]