自体血液回收机在异位妊娠破裂急诊手术中的应用效果观察  

Application of autologous blood recycling machine in emergency surgery of ectopic pregnancy ruptures

作　　者：卢金红[1] 刘文国[1] 

机构地区：[1]廊坊市第四人民医院手术室,河北廊坊065700

出　　处：《中国医学装备》2015年第8期95-98,共4页China Medical Equipment

摘　　要：目的:观察自体血液回收机在异位妊娠破裂急诊手术中的应用价值。方法:选取96例异位妊娠急诊手术患者,根据输血方式的不同,将其分为观察组和对照组。观察组50例,估计出血量>500 ml,行自体血回输;对照组46例,行单纯输注异体血。围术期持续监测自体输血患者心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、中心静脉压(CVP)以及血氧饱和度(Sp O2),同时测定术前、回输后、术后24 h白细胞(WBC)、血红蛋白(Hb)、红细胞压积(HCT)、纤维蛋白原(FIB)、血小板(PLT)、凝血酶原时间(PT)以及部分凝血活酶时间(APTT)等。记录两组失血量、回收血量及输血情况。结果:1自体血液回输后与术后24 h的SBP、MAP及CVP明显升高,差异有统计学意义(t=-1.641,t=-1.230,t=-3.591;P<0.05),术后24 h与回输前比较,差异有统计学意义(t=-1.870,t=-2.012,t=-3.205;P<0.05);2HR明显下降,回输后与回输前比较,差异有统计学意义(t=2.265,P<0.05);术后24 h与回输前比较,差异有统计学意义(t=3.018,P<0.05);3WBC、Hb、HCT及PLT明显升高,回输后与术前比较,差异有统计学意义(t=-1.831,t=-1.653,t=-1.406;P<0.05);术后24 h与术前比较,差异有统计学意义(t=-2.504,t=-1.910,t=-1.513,t=-2.310;P<0.05);4观察组异体血输注量和输血费用显著低于对照组,差异有统计学意义(t=9.362,t=5.405;P<0.05);5不良反应发生率两组相比差异有统计学意义(x2=4.22,P<0.05)。结论:在异位妊娠破裂急诊手术中,应用血液回收机进行自体血回输及时安全有效,并可显著减少输血反应和输血费用,具有重要的临床应用价值。Objective： To observe the application value of autologous blood recycling machine in emergency surgery of ectopic pregnancy ruptures. Methods： Fifty patients with ectopic pregnancy ruptures performed intraoperative autologous blood transfusion by using the autologous blood recycling machine were chosen as research group, 46 cases of same or similar patients perfonned allogeneic blood transfusion as control group. In research group,perioperative HR, SBP, DBP, MAP, CVP and SpO2 were monitored, at the same time the blood indicators as WBC, Hb, HCT, FIB, PLT, PT, APTT were examined before, after and during the operation. Blood loss, blood collection and Blood transfusion status were recorded in two groups. Results： In research group, SBP, MAP and CVP increased significantly（after transfusion compared with before transfusion, 1=-1.641, t=-1.230, I=-3.591 respectively, P〈0.05; postoperative 24h compared with before transfusion, I=-1.870, t=-2.012, t=-3.205 respectively, P〈0.05）, HR decreased significantly（after transfusion compared with before transfusion, t=2.265, P〈0.05; postoperative 24h compared with before transfusion, t=3.018, P 〈 0.05）; and WBC, Hb, HCT, PLT increased significantly （WBC, HB, HCT after transfusion compared with preoperative, t=-1.831, t=-1.653,t=-1.406 respectively, P〈0.05; postoperative 24h WBC, HB, HCT, PLT compared with preoperative, t=-2.504, t=-1.910, t=-1.513, t=-2.310 respectively, P〈0.05） after autologous blood transfusion and surgery. The volume of allogeneic blood transfusion volume, incidence of adverse reactions and costs of blood transfusion in research group were lower than those in control group（t=9.362, x2=4.22, t=5.405 respectively, P〈 0.05）. Conclusion： The operation of blood recycling machine in emergency surgery of ectopic pregnancy ruptures timely manner is safe and effective is timely, safe and effective, can significantly reduce the adverse reactions and costs of blood transfusion, has important clinical application value.

关 键 词：血液回收机 异位妊娠 破裂 

分 类 号：R713.8[医药卫生—妇产科学]