妊娠晚期储存式自体输血的临床应用效果分析  

Analysis on effects of clinical application of predeposit autologous blood transfusion in late pregnancy

作　　者：何晓峰[1,2] 杜飞[1] 蔡毅[1] 祝伶俐[1] 黄友[1] 关伟东[1] 舒虹[1] 

机构地区：[1]三峡大学人民医院输血科,湖北宜昌443000 [2]武汉大学基础医学院,武汉430071

出　　处：《检验医学与临床》2017年第17期2537-2538,2541,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨妊娠晚期储存式自体输血的临床应用效果。方法选取三峡大学人民医院2014年1月至2016年10月收治的35例Rh(D)阴性妊娠晚期孕妇进行研究,在分娩前1~3周采集自体血液200~400mL,储存在储血冰箱待分娩后回输,比较采血前后及输血前后血红蛋白(Hb)、血小板(PLT)、红细胞比容(Hct)、红细胞(RBC)变化情况,以及新生儿结局、采血与输血不良反应。结果 35例孕妇均顺利采血,采血过程中2例孕妇伴有轻微头晕症状,其余孕妇无不良反应。胎心监护未发现胎儿不良反应。采血后孕妇RBC、Hb、Hct水平下降,PLT水平增高,但采血前后比较,差异无统计学意义(P>0.05)。16例孕妇进行血液回输,无异体输血孕妇。回输前后孕妇RBC、Hb、Hct及PLT水平比较,差异无统计学意义(P>0.05)。回输过程中未发生过敏、发热及畏寒等不良反应。新生儿体质量2.53~4.08kg,平均(3.27±0.54)kg。Apgar评分10分26例,9分9例,平均(9.74±0.27)分。结论储存式自体输血在Rh(D)阴性妊娠晚期孕妇中应用安全、有效,可缓解血源紧张,推广价值较大。Objective To investigate the clinical application effects of predeposit autologous blood transfusion in late pregnancy.Methods Thirty-five late pregnant women with Rh（D）negative in our hospital from January 2014 to October 2016 were chosen to conduct research.Autologous blood 200-400 mL were collected at 1-3 weeks before childbirth,stored in the blood bank freezer and re-transfused after delivery.The changes situation of Hb,PLT,Hct,RBC,neonatal outcomes and adverse reactions of blood collection and infusion were compared between before and after blood collection.Results The process of blood collection in 35 pregnant women was smooth,mild dizziness occurred in 2 pregnant women,but no adverse reactions occurred in the rest of pregnant women.The fetal heart monitoring did not find the occurrence of fetal adverse reactions.The levels of RBC,Hb and Hct after blood collection in pregnant women were decreased,while the PLT level was increased,but there was no statistically significant difference between before and after blood collection（P0.05）.Autologous blood re-transfusion was taken in 16 pregnant women.There was no allogenetic transfusion women.There was no statistically significant difference in the levels of RBC,Hb,Hct and PLT of the pregnant women between before and after re-transfusion.No allergies,fever and chills occurred during blood re-transfusion process.The neonatal birth weights were 2.53-4.08 kg,average（3.27±0.54）kg.Apgar score was 10 points in 26 neonates and 9 points in 9 cases,average（9.74±0.27）points.Conclusion The application of predeposit autologous blood transfusion is safe and effective in late pregnant women with Rh（D）negative,could alleviate the blood source tension and has greater promotion value.

关 键 词：自体输血 储存式 妊娠晚期 RH(D)阴性 

分 类 号：R457.1[医药卫生—治疗学]