术中回收式自体输血对剖宫产术产后出血患者预后的影响  

The Effect of Intraoperative Cell Salvage on the Prognosis of Patients With Postpartum Hemorrhage Undergo Cesarean Section

作　　者：罗艳丽 冉雪莲 黄燕娟 卢可健 黄建春 LUO Yanli;RAN Xuelian;HUANG Yanjuan;LU Kejian;HUANG Jianchun(Department of Anesthesiology,The Third Affiliated Hospital of Guangxi Medical University,Nanning Guangxi 530031,China;Department of Obstetrics,The Third Affiliated Hospital of Guangxi Medical University,Nanning Guangxi 530031,China)

机构地区：[1]广西医科大学第三附属医院麻醉科,广西南宁530031 [2]广西医科大学第三附属医院产科,广西南宁530031

出　　处：《中国卫生标准管理》2022年第15期169-173,共5页China Health Standard Management

基　　金：广西壮族自治区南宁市科学研究与技术开发计划项目(南科20183037-3)。

摘　　要：目的 观察剖宫产后出血患者使用术中回收式自体输血对预后的影响。方法 前瞻性研究,观察广西医科大学第三附属医院2016年9月—2022年4月,133例剖宫产术产后出血接受输血患者,按是否使用术中回收式自体输血,分为试验组(69例)和对照组(64例)。试验组实施术中回收式自体输血,对照组输异体红细胞。观察指标:羊水栓塞等严重并发症发生率,失血量,输自体血量,输异体红细胞、血浆、冷沉淀及血小板的比例及输注量、血红蛋白(hemoglobin,Hb)、切口愈合等级、感染等手术并发症发生率、ICU入住率及停留时间、住院时间和术后住院时间等。结果 两组无羊水栓塞等严重并发症发生,与对照组比,试验组输异体红细胞及血浆的比例和输注量均较少,差异有统计学意义(P <0.05);两组术后24 h及出院的Hb值、输血相关不良反应、手术并发症、伤口愈合不良、ICU入住率及停留时间、住院时间和术后住院时间等指标差异无统计学意义(P> 0.05)。结论 术中回收式自体输血用于剖宫产患者产后出血无羊水栓塞等严重并发症发生,可减少异体红细胞和血浆的输注,安全有效。Objective To observe the effect of intraoperative cell salvage on the prognosis of patients with postpartum hemorrhage after cesarean section. Methods In a prospective study, a total of 133 patients with postpartum hemorrhage undergo cesarean section who received intraoperative cell salvage were observed in The Third Affiliated Hospital of Guangxi Medical University from September 2016 to April 2022(69 cases in the experimental group and 64 cases in the control group). The experimental group was used intraoperative cell salvage underwent cesarean section and the control group was received allogeneic red blood cells. The incidence of severe complications such as amniotic fluid embolism, the volume of blood loss, autologous blood and allogeneic red blood cells, the proportion and volume of plasma,cryoprecipitate and platelet transfusion, hemoglobin(HB),wound healing grade, incidence of surgical complications such as infection, ICU occupancy rate and ICU stay, hospitalization days and postoperative hospitalization days were observed.Results There were no severe complications such as amniotic fluid embolism in the two groups. Compared with the control group, the proportion and volume of allogeneic red blood cells and plasma in the experimental group were less, the difference were statistically significant(P < 0.05). There was no significant difference between the two groups in terms of postoperative 24 h Hb, discharge Hb, transfusion-related adverse reactions, surgical complications, the rate of poor wound healing grade, ICU occupancy rate, ICU stay, hospitalization days and postoperative hospitalization days(P > 0.05). Conclusion Intraoperative cell salvage can reduce the transfusion of allogeneic red blood cells and plasma, which is safe and effective for the postpartum hemorrhage patients undergo cesarean section without severe complications such as amniotic fluid embolism.

关 键 词：剖宫产术 产后出血 输血治疗 术中回收式自体输血 手术并发症 患者预后 

分 类 号：R714[医药卫生—妇产科学]