胎儿宫内输血临床疗效及护理经验总结  

Clinical Efficacy and Nursing Care of Fetal Intrauterine Blood Transfusion:Previous Experience Review

作　　者：董淼[1] 姜梅[2] DONG Miao;JIANG Mei(Specialist Consultation Outpatient Service,Beijing Obstetrics and Gynecology Hospital,Capital Medical University/Beijing Maternal and Child Health Care Hospital,Beijing 100026,China;Nursing Department,Beijing Obstetrics and Gynecology Hospital,Capital Medical University/Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院特需门诊,北京100026 [2]首都医科大学附属北京妇产医院/北京妇幼保健院护理部,北京100026

出　　处：《四川大学学报（医学版）》2023年第4期843-847,共5页Journal of Sichuan University(Medical Sciences)

摘　　要：目的总结胎儿贫血病例接受宫内输血(intrauterine blood transfusion,IUT)治疗的临床疗效及护理经验。方法收集2020–2022年在首都医科大学附属北京妇产医院接受IUT的4例胎儿贫血病例资料。4例孕妇年龄24~38岁,胎儿贫血原因不明。4例孕妇得知胎儿贫血后均产生焦虑情绪,因此在IUT术前对孕妇进行一对一心理辅导,术中进行一对一陪伴,且密切检测有无输血反应,术后观测穿刺部位并对新生儿进行24 h监护。结果4例孕妇分别于孕中期及孕晚期行1~3次IUT,最小输血孕周为25+周,输血量20~107 mL/次。除有2例孕妇曾在孕晚期IUT过程中出现不规律宫缩以外,其余IUT治疗过程均顺利。经IUT后胎儿血红蛋白、大脑中动脉收缩期峰值速度、心胸面积比明显改善,除1例孕妇未在本院分娩,无法得知胎儿结局外,其余3例胎儿均获得良好结局。结论术前对孕妇进行积极的心理疏导,术中术后进行严密的孕期监测及母胎并发症的预防,是提高IUT临床疗效,获得良好胎儿结局的关键。Objective To summarize the clinical efficacy and nursing experience of intrauterine blood transfusion(IUT)treatment for fetal anemia cases.Methods The clinical data of 4 fetal anemia cases receiving IUT in Beijing Obstetrics and Gynecology Hospital,Capital Medical University between 2020 and 2022 were collected.Four pregnant women aged 24-38 years were included in the study.They carried fetuses with anemia of unknown causes.The four pregnant women developed anxiety after they were informed of the diagnosis of fetal anemia.One-on-one psychological counseling before the IUT procedure and one-on-one companionship over the course of the surgery were provided for the pregnant women.In addition,they were closely monitored for blood transfusion reactions.Postprocedural observation of the puncture site and 24-hour monitoring of the newborns were also conducted.Results The four pregnant women underwent 1-3 times of IUT in the second and third trimesters,with the minimum gestational age at the time of IUT being 25+weeks and the blood transfusion volume being 20-107 mL/time.Two pregnant women experienced irregular uterine contractions during IUT in the third trimester.Other than that,all other IUT treatments were successful.After IUT,there was a significant improvement in fetal hemoglobin,peak systolic velocity of the middle cerebral artery(MCA-PSV),and cardiothoracic area ratio.One case did not give birth in our hospital and the outcome of the fetus was not known.The other three fetuses achieved good outcomes.Conclusion Positive preprocedural psychological counseling for pregnant women,close intraoprocedural and postprocedural pregnancy monitoring,and the prevention of maternal and fetal complications are the key to improving the clinical efficacy of IUT and achieving a good fetal outcome.

关 键 词：胎儿贫血 宫内输血 围术期护理 

分 类 号：R473.71[医药卫生—护理学]