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目的:探讨急性等容稀释性自体输血在剖宫产手术中应用的安全性和有效性。方法:以行急性等容稀释性自体输血的56例剖宫产手术患者为研究对象(ANH组),对照组为随机抽取同期住院行剖宫产术的孕妇51例。记录手术前后红细胞(RBC)、血红蛋白(Hb)、血细胞比容(HCT)、血小板计数(PLT)等血液指标变化情况,同时观察术中出血量、自体血采集及回输过程中不良反应、新生儿产后情况等。结果:1术后2d对照组RBC、Hb及HCT明显下降,与术前比较差异有统计学意义(P<0.05);而ANH组RBC、Hb及HCT稍有下降,与术前比较差异无统计学意义(P>0.05);与对照组术后比较差异均有统计学意义(均P<0.05)。2ANH组患者自体血采集及回输过程中均无不适,未发生严重不良反应,术中未输注异体血。新生儿Apgar评分9~10分,随访新生儿产后情况良好。结论:急性等容稀释性自体输血应用于剖宫产手术操作简单,不良反应少,能减少异体血输注,是一种安全有效的输血方式。
Objective: To investigate the safety and efficacy of acute isovolumic autotransfusion in cesarean section. Methods: Fifty-six patients undergoing cesarean delivery with acute isovoleus dilutional autotransfusion (ANH group) were enrolled. The control group consisted of 51 pregnant women randomly selected for cesarean section during the same period. The changes of blood indexes such as RBC, Hb, HCT and PLT before and after operation were recorded. At the same time, the intraoperative blood loss, adverse reaction during autologous blood collection and transfusion, After childbirth and so on. Results: 1 The RBC, Hb and HCT in the control group decreased significantly at 2 days after operation compared with the preoperative level (P <0.05); while the RBC, Hb and HCT decreased slightly in the ANH group, with no statistical difference (P> 0.05). There were significant differences between the two groups (P <0.05). In the 2ANH group, there was no discomfort during autologous blood collection and transfusion, no serious adverse reactions occurred, and no allogeneic blood was transfused. Neonatal Apgar score 9 to 10 points, follow-up of newborns in good condition after childbirth. CONCLUSION: Acute isovolumic autotransfusion is a safe and effective blood transfusion for cesarean section with simple operation, less adverse reactions and less allogeneic blood transfusion.