回收式自体输血联合白细胞过滤器对剖宫产母体免疫功能的影响  

Effect of recycled autologous blood transfusion combined with leukocyte depletion filter on maternal immune function in women undergoing Cesarean section

作　　者：陈皆锋[1] 丁洁岚[1] 周立旺[1] 潘郑斌 高利卿 柯燕君 水维维 CHEN Jiefeng;DING Jielan;ZHOU Liwang(Department of Anesthesiology,Shaoxing Maternity and Children Care Hospitals Shaoxing 312000,CHINA)

机构地区：[1]绍兴市妇幼保健院麻醉科,浙江312000

出　　处：《江苏医药》2021年第5期483-486,共4页Jiangsu Medical Journal

基　　金：浙江省绍兴市科技计划项目(2018C30041)。

摘　　要：目的探讨回收式自体输血联合白细胞过滤器对剖宫产母体免疫功能的影响。方法行剖宫产手术的产妇40例分为两组,每组20例。观察组术中实施自体输血联合白细胞过滤器,对照组行异体输血。记录手术出血量和输血量。检测术前(T0)、输血后2 h(T1)、24 h(T2)和术后5 d(T3)炎症反应和细胞免疫功能相关指标水平。结果观察组输血前Hb高于对照组(P<0.05)。与T0比较,两组产妇IL-6浓度T1、T2时升高,IL-8浓度T1~T3时升高(P<0.05)。与T0比较,观察组CD^(4+)水平T3时升高,CD^(4+)/CD^(8+)比值T2时降低,NK细胞水平T3时降低(P<0.05);对照组CD^(3+)水平T2、T3时降低,CD^(4+)和CD^(8+)比值T1、T2时降低,CD^(4+)/CD^(8+)比值和NK细胞水平T1~T3时降低(P<0.05)。与对照组比较,观察组IL-6和IL-8浓度T1、T2时降低;观察组CD^(3+)水平T2、T3时升高,CD^(4+)水平和CD^(4+)/CD^(8+)比值T1~T3时升高,CD^(8+)和NK细胞水平T2时升高(P<0.05)。结论剖宫产术中应用回收式自体输血联合白细胞过滤器对母体免疫功能的影响较小,是一种安全、有效、经济的输血方式。Objective To investigate the effect of recycled autologous blood transfusion combined with leukocyte depletion filter on maternal immune function in women undergoing Cesarean section.Methods Forty women undergoing Cesarean section were divided into two groups with 20 cases each.During operation, group A was treated with recycled autologous blood transfusion combined with leukocyte depletion filter and group B was treated with allogeneic blood transfusion.The operative blood loss and blood transfusion volume were recorded.Perioperative Hb and inflammatory response and immune function-related indicators were detected at the time points of before operation(T0),2 h(T1) and 24 h(T2) after transfusion and 5 days(T3) after surgery.Results Hb at T0 was higher in group A than that in group B(P<0.05).Compared with T0,the concentration of IL-6 was increased at T1 and T2,and that of IL-8 was increased at T1 to T3 in both groups(P<0.05).Compared with T0,the CD^(4+) level at T3 was increased, and the ratio of CD^(4+) to CD^(8+) at T2 and NK cell level at T3 were decreased in group A(P<0.05).Compared with T0,the CD^(3+) levels at T2 and T3 were decreased, CD^(4+) and CD^(8+) levels were decreased at T1 and T2,and the ratio of CD^(4+)to CD^(8+) and NK cell levels were decreased at T1 to T3 in group B(P<0.05).Compared with group B,the concentrations of IL-6 and IL-8 at T1 and T2 were decreased, CD^(3+) levels at T2 and T3 were increased, CD^(4+) level and the ratio of CD^(4+)to CD^(8+) at T1 to T3 were increased, and CD^(8+) and NK cell levels at T2 were increased(P<0.05).Conclusion The use of recycled autologous blood transfusion combined with leukocyte depletion filter in women undergoing Cesarean section is a safe, effective and economical way of blood transfusion with little effect on maternal immune function.

关 键 词：回收式自体输血 异体输血 剖宫产 白细胞过滤器 

分 类 号：R714[医药卫生—妇产科学]