凶险性前置胎盘行剖宫产时两种自体血回输应用比较  

Two Kinds of Autologous Blood Component Transfusion during Pernicious Placenta Previa Cesarean Section

作　　者：林毅[1] 张仕铜[1] 严海雅[1] 赵羽玲[1] 

机构地区：[1]宁波市妇女儿童医院,浙江宁波315012

出　　处：《实用妇产科杂志》2016年第1期38-41,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:比较回收式和稀释式自体血回输在凶险性前置胎盘行剖宫产时的应用情况。方法:选择2011年6月至2013年6月在本院住院的因凶险性前置胎盘拟行剖宫产术的患者60例,根据自体血回输的方法分成两组,Ⅰ组(n=30)为回收式自体血回输,Ⅱ组(n=30)稀释式自体血回输。观察两组术中出血、输血情况、新生儿评分、脐动脉血p H值比较,检测两组产妇自体采血前(T1)、采血后即刻(T2)、关腹时(T3)、术后24小时(T4)各时点的血流动力学指标、血红蛋白(Hb)水平、血细胞比容(Hct)、血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)。结果:两组产妇血流动力学指标稳定,组间比较差异无统计学意义(P>0.05)。两组新生儿1分钟、5分钟Apgar评分比较,组间差异无统计学意义(P>0.05)。两组产妇术后的Hb、Hct、PLT、PT、APTT、Fib组间比较差异无统计学意义(P>0.05)。两组并发症比较差异有统计学意义(P<0.05)。结论:回收式和稀释式两种自体血回输在应用上无明显差异,但是回收式自体血回输具有并发症少、使用灵活、使用指征宽的优点。Objective： To compare outcomes between salvaged blood autotransfusion and hemodilutional blood autotransfusion during pernicious placenta previa cesarean section. Methods： 60 cases who underwent cesarean section because of pernicious placenta previa in Ningbo women and children＇s Hospital from June 2011 to June 2013 were collected and divided into salvaged blood autotransfusion group（ group Ⅰ,n = 30） and hemodilutional blood autotransfusion group（ group Ⅱ,n = 30）. The bleeding amount and transfusion amount during surgery were recorded. The hemodynamic indexes,hemoglobin（ Hb）,hematocrit（ Hct）,platelet（ PLT）,prothrombin time（ PT）,activated partial thromboplastin time（ APTT）,fibrinogen（ Fib） of the maternal during surgery（ T1-4） were recorded.The Apgar score of the neonates and p H of the umbilical cord blood were assessed. Results： The hemodynamics of two groups was stable and without statistical difference（ P0. 05）. No statistical significant difference of maternal Hb,Hct,PLT,PT,APTT,Fib was found between two groups（ P0. 05）. No significant difference of neonatal Apgar scores at either 1 or 5 minutes after born was found between two groups（ P0. 05）. Conclusions： Two kinds of autologous blood transfusion has no statistical significant differences in the application. However,the salvaged blood autotransfusion has the advantages of fewer complications,more flexible application,wider range of indications

关 键 词：回收式自体血回输 稀释式自体血回输 凶险性前置胎盘 

分 类 号：R714.56[医药卫生—妇产科学]