回收式自体输血对高危剖宫产妇凝血功能及血液中胎儿成分的影响  

Effects of Intraoperative Cell Salvage on Coagulation and Fetal Components in High-risk Cesarean Section

作　　者：王瑞含 彭娟[2] 刘浩 刘久波[2] WANG Rui-han;PENG Juan;LIU Hao(Department of Clinical Laboratory,The Second Hospital of Tianjin Medical University,Tianjin 300000)

机构地区：[1]天津医科大学第二医院检验科,300000 [2]湖北医药学院附属太和医院输血医学科

出　　处：《临床输血与检验》2023年第2期215-219,共5页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：湖北省卫生健康委2019年输血专项-重点项目(No.WJ2019H344)资助。

摘　　要：目的探究回收式自体输血洗涤、过滤过程对高危剖宫产妇血液中胎儿成分及凝血功能的影响,证明回收式自体输血在剖宫产手术应用中的安全性。方法选取在某三甲医院产科进行剖宫产手术分娩并行回收式自体输血的高危产妇50例为观察组,并选取同期对照组50例,收集观察组胎儿娩出后的母体静脉血、洗涤前血样、洗涤后血样、过滤后血样,分别检测比较各血样中胎儿鳞状上皮细胞、胎儿红细胞、甲胎蛋白和组织因子含量,并比较两组产妇手术前后血液中胎儿成分含量和凝血功能。结果两组产妇术前及术后PT、APTT、Fib、甲胎蛋白、组织因子比较,组间无显著差异(P>0.05)。与洗涤前血样相比,洗涤后血样胎儿红细胞计数、甲胎蛋白、组织因子的浓度显著降低(P<0.05);与洗涤后血样相比,过滤后血样胎儿鳞状上皮细胞计数、胎儿红细胞计数、甲胎蛋白显著降低(P<0.05)。结论回收式自体输血对产妇凝血功能影响较小,对血液中胎儿成分滤除效果好,安全性高,适宜在临床推广应用。Objective To explore the effect of the washing and filtering process of intraoperative cell salvage on coagulation and fetal composition of high-risk cesarean section women,and to prove the safety of intraoperative cell salvage in the application of cesarean section.Methods Fifty high-risk women who underwent cesarean section and IOCS in the obstetrics department of a tertiary hospital were selected as the observation group,and 50 cases during the same period were selected as the control group.Maternal venous blood after delivering,pre-washing blood sample,post-washing blood sample,and filtered blood sample in observation group were collected.Fetus squamous epithelial cells,fetal red blood cells,alpha-fetoprotein and tissue factor were detected.The blood coagulation and fetal components were compared between the two groups before and after the operation.Results There was no significant difference in PT,APTT,Fib,alpha-fetoprotein and tissue factor between the two groups before and after operation(P>0.05).Compared with the blood sample before washing,the fetal red blood cells,alpha-fetoprotein and tissue factor of the blood sample after washing were significantly reduced in observation group(P<0.05).Compared with the blood sample after washing,the fetal epithelial cells,fetal red blood cell counts,alpha-fetoprotein and tissue factor of the filtered blood sample were significantly reduced(P<0.05).Conclusion Intraoperative cell salvage has little effect on maternal coagulation function.It has a good filtering effect on amniotic fluid components,high safety,and suitable for clinical application.

关 键 词：术中回收式自体输血 剖宫产 凝血功能 胎儿成分 

分 类 号：R457[医药卫生—治疗学]