剖宫产应用自体血回收联合白细胞过滤器对患者血常规及生化指标影响的观察  

Effect of autologous blood recovery combined with leukocyte filter on blood routine and biochemical index in patients with cesarean section

作　　者：何明海 蔡回钧 芶大明[1,2] He Minghai;Cai Huijun;Gou Darning(Anesthesiology Medical School,Zunyi Medical University,Guizhou Key Laboratory of Anesthesia and Organ Protection,Zunyi Guizhou 563099,China;Department of Anesthesiology,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563099,China)

机构地区：[1]遵义医学院麻醉医学院暨贵州省麻醉与器官保护重点实验室,贵州遵义563099 [2]遵义医学院附属医院麻醉科,贵州遵义563099

出　　处：《遵义医学院学报》2017年第6期660-664,共5页Journal of Zunyi Medical University

基　　金：国家自然科学基金资助项目(NO:61560080)

摘　　要：目的观察剖宫产手术术中发生急性大出血的患者应用自体血回收联合白细胞过滤器对血常规及生化指标的影响。方法选取遵义医学院附属医院2015年10月至2017年5月剖宫产手术术中发生急性大出血的患者16例,术中应用自体血回收联合白细胞过滤器进行回收式自体输血,分别于术前、术后第1天及术后第3天测定患者白细胞数(WBC)、中性粒细胞数(NEUT)、血红蛋白浓度(Hb)、血钾浓度(K^+)、间接胆红素浓度(IBIL)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)以及纤维蛋白原(FIB)。结果 16例患者回输自体血共计15 600 m L,平均每例患者回输自体血量为975m L,回收式自体输血后所有患者术中生命体征平稳。与术前比较,术后第1天的WBC、NEUT、IBIL增高,APTT时间延长、FIB降低,差异均有统计学意义(P<0.05),K^+、Hb、PT,差异无统计学意义(P>0.05),术后第3天各观察指标差异无统计学意义(P>0.05)。与术后第1天比较,术后第3天的WBC、PT及APTT降低,差异均有统计学意义(P<0.05),NEUT、K^+、Hb、IBIL,差异无统计学意义(P>0.05)。结论在剖宫产手术术中发生急性大出血的患者应用自体血回收联合白细胞过滤器对血常规及生化指标无影响。Objective To examine leukocyte filter on blood routine and biochemical indexes in patients undergoing cesarean section undergoing acute massive hemorrhage.Methods Selection of16cases of acute hemorrhage in cesarean section from October2015to May2017in Affiliated Hospital of Zunyi Medical University.The intraoperative autologous blood recovery combined with leukocyte filter for autotransfusion was applied,and white blood cell count(WBC),neutrophil count(NEUT),hemoglobin(Hb),potassium(K+),indirect bilirubin(IBIL),prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen(FIB)were determined on preoperation and postoperative1d and3d,respectively.Results16patients returned to the total amount of autologous blood total15600mL,the average return of blood in each patient was975ml.All patients’vital signs were stable after autologous blood transfusion.Compared with preoperative,WBC,NEUT,IBIL increased,APTT prolonged,FIB decreased on the first postoperative day,the difference was statistically significant(P<0.05),K+,Hb,PT,the difference was not statistically significant(P>0.05).There was no significant difference in each observation index on the3rd postoperative day(P>0.05).Compared with the first day after operation,the WBC,PT and APTT decreased on the third day after operation,the difference was statistically significant(P<005),for NEUT,K+,Hb,IBIL,the difference was not statistically significant(P>0.05).Conclusion In patients undergoing cesarean section with acute massive hemorrhage,the use of autologous blood recovery combined with leukocyte filters had no effect on blood routine and biochemical parameters.

关 键 词：剖宫产 自体血 白细胞过滤器 血常规 生化指标 

分 类 号：R719.8[医药卫生—妇产科学]