回收式自体输血联合双侧髂内动脉预置术对出血高危患者在剖宫产术中的应用  

Application of recovery autologous blood transfusion combined with bilateral internal iliac artery presetting in high-risk patients with hemorrhage during cesarean section

作　　者：方进龙[1] 周晓琴 涂远艳[1] 王向东[1] 杨益刚 吴远军 FANG Jinlong;ZHOU Xiaoqin;TU Yuanyan;WANG Xiangdong;YANG Yigang;WU Yuanjun(Dongguan Maternal and Child Health Hospital,Dongguan 523000,China;Dongguan Hospital of Guangzhou University of Chinese Medicine.)

机构地区：[1]东莞市妇幼保健院,广东东莞523000 [2]广州中医药大学东莞医院

出　　处：《中国输血杂志》2023年第12期1114-1118,共5页Chinese Journal of Blood Transfusion

基　　金：东莞市社会发展科技面上项目(20211800901702)。

摘　　要：目的探讨回收式自体输血联合双侧髂内动脉球囊预置术对出血高危患者在剖宫产术中的应用效果。方法前瞻性选取本院2021年1月—2023年5月的162名进行剖宫产的出血高危患者,根据输血方式适应证不同分为A、B、C 3组,每组各54例。A组采用异体血输入,B组采用自体血输入,C组采用自体输血联合双侧髂内动脉球囊预置术。结果术中出血量(1600 mL vs 1500 mL vs 800 mL)、术后住院时间(7 d vs 7 d vs 6 d)和手术时间(107 min vs 104.50 min vs 77 min)C组均低于A、B 2组(P<0.05),A、B 2组比较无差异(P>0.05);C组输入自体血量低于B组(525.5 mL vs 261 mL,P<0.05)。C组异体红细胞的输入占比低于A组(22.22%vs 100.00%,P<0.0167);C组血浆的输入占比低于A、B 2组(18.50%vs 66.70%/18.50%vs 44.40%,P<0.0167);C组凝血功能障碍发生率低于A组(7.41%vs 25.93%,P<0.0167);C组子宫切除发生率低于A组(1.85%vs 16.67%,P<0.0167),A、B 2组比较无差异(16.67%vs 11.11%,P>0.0167)。结论在出血高危患者剖宫产术中采用回收式自体输血联合双侧髂内动脉球囊预置术效果理想,能明显减少术中失血量、术中自体血回输量、异体红细胞和血浆成分的输入量,同时减少手术时间和术后住院时间。此外,还改善凝血功能和子宫切除情况,有利于保障产妇的生命安全和促进早期康复,且一定程度保留患者生育能力,值得临床进一步推广。Objective To explore the effect of recovery autologous blood transfusion combined with bilateral internal iliac artery presetting in high-risk patients with hemorrhage during cesarean section.Methods A total of 162 high-risk patients with hemorrhage who underwent cesarean section from January 2021 to May 2023 in our hospital were prospectively selected and divided into in Groups A,B,and C with 54 cases in each group according to the indications for the method of transfusion.Group A received allogeneic blood transfusion,Group B received autologous blood transfusion,Group C received autologous blood transfusion combined with bilateral internal iliac artery balloon presetting.Results Intraoperative blood loss(mL)(1600 vs 1500 vs 800),postoperative hospital stay(d)(7 vs 7 vs 6)and operative time(min)(107 vs 104.50 vs 77)in group C were all lower than those in group A and B(P<0.05),with no difference between group A and B(P>0.05);The autologous blood transfusion volume(mL)in group C was lower than that in group B(525.5 vs 261,P<0.05).The proportion of allogeneic erythrocytes in group C was lower than that in group A(22.22%vs 100.00%,P<0.0167).The proportion of plasma in group C was lower than that in groups A and B(18.50%vs 66.70%/18.50%vs 44.40%,P<0.0167).The incidence of coagulating dysfunction in group C was lower than that in group A(7.41%vs 25.93%,P<0.0167).The incidence of hysterectomy in group C was lower than that in group A(1.85%vs 16.67%,P<0.0167),and there was no difference between group A and B(16.67%vs 11.11%,P>0.0167).Conclusion Recovery autologous blood transfusion combined with bilateral internal iliac artery balloon presetting in cesarean section for high-risk patients with hemorrhage achieved ideal effects,which can significantly reduce intraoperative blood loss,intraoperative autologous blood transfusion,allogeneic red blood cells and plasma transfusion,as well as the operation time and postoperative hospital stay.In addition,it can improve the coagulation function and hysterectomy,which is conduciv

关 键 词：回收式自体输血 双侧髂内动脉预置术 出血高危患者 剖宫产术 

分 类 号：R457.1[医药卫生—治疗学] R719.8[医药卫生—临床医学]