摘要
目的：评价剖宫产术中自体血回收的可靠性。方法选择术前超声和磁共振诊断为凶险型前置胎盘和∕或胎盘植入的剖宫产术患者15例，年龄20～35岁，体重55～75 kg，孕周≥36周，术中将术野出血和羊水一同收集到储血罐内，经过洗涤的回收血利用重力作用通过白细胞滤器进行过滤。采集胎儿娩出后的母体静脉血样、洗涤前血样、洗涤后血样和过滤后血样各20 ml，采用巴氏染色法检测胎儿鳞状上皮细胞计数，酶联免疫吸附法检测甲胎蛋白、组织因子、内皮素？1及组胺的浓度，酸洗脱染色法检测胎儿红细胞计数。结果与洗涤前血样比较，洗涤后血样组织因子浓度升高，胎儿鳞状上皮细胞计数、甲胎蛋白、内皮素？1的浓度和胎儿红细胞降低（ P＜0．05）；与洗涤后血样比较，过滤后血样胎儿鳞状上皮细胞计数、甲胎蛋白浓度和胎儿红细胞降低（ P＜0．05）；与母体静脉血样比较，过滤后血样组织因子浓度升高，胎儿鳞状上皮细胞计数、甲胎蛋白和内皮素？1的浓度降低（P＜0．05）。结论剖宫产术中回收的自体血可用于回输。
Objective To evaluate the reliability of autologous blood withdrawal during cesarean section. Methods Fifteen patients preoperatively diagnosed with pernicious placenta previa and∕or accrete by using ultrasound and magnetic resonance imaging, aged 20-35 yr, weighing 55-75 kg, at≥36 weeks of gestation, were enrolled in the study. Blood containing amniotic fluid from the surgical field was collected, and the washed blood was processed using cell-salvage machine and then filtered using a leukocyte depletion filter during cesarean section. The 20 ml blood samples collected included maternal central venous blood after delivery of fetus, unwashed blood, washed blood and filtered blood. The fetal squamous cells were counted using papanicolaou staining. The concentrations of a-fetoprotein, tissue factor, endothelin-1 and histamine were measured by enzyme linked immunosorbent assay. The fetal red blood cells were counted using the acid elution method and HE staining. Results Compared with unwashed samples, the tissue factor concentrations were significantly increased, and the fetal squamous cell count, concentrations of a-fetoprotein and endothelial-1, and fetal red blood cells were decreased in the washed samples. Compared with washed samples, the fetal squamous cell count, concentrations of a-fetoprotein and fetal red blood cells were significantly decreased in filtered samples. Compared with maternal venous blood samples, the tissue factor concentrations were significantly increased, and the fetal squamous cell count and concentrations of a-fetoprotein and endothelial-1 were decreased in filtered samples. Conclusion Autologous blood withdrawn during cesarean section can be used for reinfusion in cesarean section.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2015年第5期598-600,共3页
Chinese Journal of Anesthesiology
关键词
输血
自体
剖宫产术
Blood transfusion
autologous
Cesarean section
