自体血回输对异位妊娠大出血患者内脏灌注及氧合的影响  

Effect of autologous blood transfusion on visceral perfusion and oxygena-tion in patients with ectopic pregnancy bleeding

作　　者：冉雪莲[1] 陈峻[2] 秦东全 黄燕娟[1] 

机构地区：[1]广西医科大学附属第三医院麻醉科,广西南宁530031 [2]广西医科大学附属民族医院麻醉科,广西南宁530021

出　　处：《中国医药导报》2015年第14期78-81,共4页China Medical Herald

摘　　要：目的观察回收式自体血回输与血库血输入对异位妊娠大出血患者内脏灌注及氧合的影响。方法 40例异位妊娠大出血需输血治疗的手术患者随机分为两组:自体输血组(Z组)和对照组(Y组,输入库存异体血),每组各20例。分别记录两组患者的生命体征、输液量、出血量、血氧饱和度(Sp O2)、气道压力(AWP);记录术前(T1)、术毕(T2)和术后24 h(T3)的血常规、凝血功能、动脉血p H值(p Ha)、动脉血二氧化碳分压(Pa CO2)、剩余碱(BE)值、乳酸(Lac)、胃黏膜p H值(p Hi)、胃黏膜二氧化碳分压差(Pg CO2)和胃黏膜-动脉二氧化碳分压差[P(g-a)CO2]及异体血输入量。结果两组输液量、出血量、血红蛋白(Hb)、血细胞比较(Hct)、凝血酶原时间、纤维蛋白原、p Ha、Pa CO2、Lac、Pg CO2、P(g-a)CO2比较差异无统计学意义(P>0.05);与Y组比较,Z组输注异体浓缩红细胞量及血浆量明显减少(P<0.05),BE、p Hi明显增高(P<0.05)。与T1比较,两组T2、T3时点p Ha、Pa CO2、BE、Lac、p Hi显著增高(P<0.05),P(g-a)CO2显著降低(P<0.05)。结论自体血回输能改善异位妊娠大出血患者内脏灌注及氧合,减少异体血用量,对于异位妊娠大出血患者值得大力推广。Objective To observe the recovery of autologous blood transfusion and blood bank blood input impact on visceral perfusion and oxygenation in patients with ectopic pregnancy bleeding. Methods 40 patients with ectopic pregnancy bleeding required operation and blood transfusion were randomly divided into two groups： autologous blood transfusion group （group Z） and control group （group Y, input inventory of homologous blood）, with 20 cases in each group. Vital signs, blood oxygen saturation （Sp02）, airway pressure （AWP） of two patients in two groups were respectively recorded; before the group （T1）, the arterial pHa, PaCO2, BE value, pHi, lactic acid, PgCO2, P（g-a）CO2 at the end of operation （T2） and 24 h after operation （T3） and the amount of blood transfusion of two patients were respectively recorded. Results There was no significant difference in the amount of fluid transfusion, the amount of blood transfusion, Hb, Hct, PT, FIB, pHa, PaCO2, Lac, PgCO2, P（g-a）CO2 in two groups （P 〉 0.05）. Compared with group Y, RBC and plasma volume in group Z were significantly decreased, and BE, phi in group Z were significantly increased （P 〈 0.05）. Compared with T1, pHa, PaCO2, BE, Phi, Lac at T2-T3 in two groups were significantly increased, and P（g-a） CO2 was significantly decreased （P 〈 0.05）. Conclusion Autologous blood transfusion can improve visceral perfusion and oxygenation in patients with ectopic pregnancy bleeding, reduce the amount of allogeneic blood transfusion, for ectopic pregnancy patients with massive hemorrhage should be vigorously promoted.

关 键 词：自体血回输 异位妊娠 出血 内脏灌注 氧合 

分 类 号：R457.1[医药卫生—治疗学]