急性等容稀释联合回收式自体输血在前置胎盘手术中的应用  

Application of acute normovolemic hemodilution combined with autologous transfusion salvage in placenta previa surgery

作　　者：朱明慧[1] 王英[1] 杨文丽[1] 宋雪冬[2] 

机构地区：[1]廊坊市第四人民医院妇产科,河北廊坊065700 [2]廊坊市第四人民医院检验科

出　　处：《临床血液学杂志（输血与检验）》2017年第1期116-119,共4页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

摘　　要：目的:探讨急性等容稀释(ANH)联合回收式自体输血在前置胎盘手术中的应用效果。方法:选择ANH联合术中回收式自体输血68例前置胎盘手术患者为观察组,对照组为随机抽取无自体输血的前置胎盘手术患者54例。记录手术前后RBC、Hb、HCT、WBC、PLT、PT、APTT等指标变化情况,同时观察术中出血量、自体血采集及回输过程中不良反应情况等。对2组术后康复情况进行随访。结果:(1)2组失血量差异无统计学意义(P>0.05),观察组术前预存血量(565±198)ml、术中回收血量(612±137)ml,库血输注例数和库血用量明显少于对照组(P<0.05);(2)2组术后24hRBC、Hb、HCT、WBC、PLT、PT、APTT等血液指标与本组术前比较,差异均有统计学意义(均P<0.05),但术后24h2组间比较差异无统计学意义(P>0.05);(3)观察组患者自体血采集及回输过程中均未发生严重不良反应;(4)观察组术后肠道排气时间、切口拆线时间及住院时间均明显少于对照组,差异有统计学意义(P<0.05)。结论:ANH联合回收式自体输血应用于前置胎盘手术,具有较好的血液保护效果和临床推广价值。Objective：To explore the application effect of acute normovolemic hemodilution （ANH） combined with autologous transfusion salvage in placenta previa surgery. Method：A total of 68 patients with placenta previa surgery implemented ANH combined with autologous transfusion salvage were chose as observation group, ran- dom samples of 54 patients with placenta previa surgery without autologous transfusion in our hospital as control group. The changes of blood indicators as RBC, Hb, HCT, WBC, PI.T, PT and APTT before and after surgery were recorded, and intraoperative blood loss, adverse reactions in the process of autologous blood collection and transfusion were observed. The situations of postoperative recovery were recorded in two groups. Result： ①The blood loss volumes was no statistical difference （P〉0.05）. The volume of preoperative prestore blood and intrao- perative blood collection were （565±198） ml and （612 ±137） ml in observation group, respectively. The cases and volume of banked blood infusion in observation group were lower than those in control group （P〈0.05）. ② Compared with preoperative, the blood indicators such as RBC, Hb, HCT, WBC, Ph, PT and APTT at postop- erative 24h, the differences were statistically significant （P〈0.05） in two groups, and the blood indicators at postoperative 24h of two groups were no obvious difference （P〉0.05）. （3）No serious adverse reactions happened among the process of autologous blood collection and transfusion in observation group. ③The intestinal exhaust time, incision stitches take-out time and hospital stay in observation group were less than those in control group （P〈0.05）. Conclusion： Application effect of ANH combined with autologous transfusion salvage in placenta pre via surgery might be remarkable, which would have good blood conservation effect and clinical value.

关 键 词：急性等容稀释 自体血回输 前置胎盘 手术 

分 类 号：R457.1[医药卫生—治疗学]