摘要
目的:探讨大量输血方案在抢救凶险型前置胎盘(PPP)产后大出血患者中的临床意义,为该类大量输血患者制定更合理的输血救治方案提供临床依据。方法:回顾分析2011年1月至2015年11月我院收治的67例PPP产后大出血患者的临床资料,根据是否使用MTP进行输血抢救,把患者分成"MTP组"(32例)和"非MTP组"(35例)。结果:抢救时MTP组的Hb、PLT、PT、APTT、TT、FIB、p H值及[HCO_3^-]值与非MTP组比较,差异有统计学意义(P<0.05)。两组患者的复苏时间、24h出血量、子宫切除率比较,差异均有统计学意义(P<0.05)。复苏后期MTP组的Hb、PLT、FIB偏离值均明显低于非MTP组(P<0.05)。两组患者的输血并发症风险和输血费用比较,差异无统计学意义(P>0.05)。结论:MTP的制定融合了多学科优势,使用MTP可高效、安全地抢救PPP产后大出血患者,且不增加患者输血成本,有效保留患者的生育能力。
Objective: To explore the value of MTP used in rescuing pernicious placenta previa patients with postpartum hemorrhage,and provide more clinical evidences for drawing up the reasonable transfusion treatment scheme for those massive transfusion patients. Methods: 67 massive transfusion patients with pernicious placenta previa were reviewed retrospectively. They were chosen in our hospital from Jan. 2011 to Nov. 2015,and divided into two groups: MTP group( 32 patients used MTP in rescuing) and n-MTP group( 35 patients used MTP in rescuing). Results: In rescuing time,the lost values of Hb,PLT,FIB,PH and [HCO_3^-]in MTP group were significantly lower than those in n-MTP group( P<0. 05). The times extended of PT,APTT,TT in MTP group were significantly shorter than those in n-MTP group( P<0.05). The recovery times of MTP group were significantly shorter than those of n-MTP group( P<0. 05). The amounts of bleeding in 24 h of MTP group were significantly lower than those of nMTP group( P<0. 05). After revived,the lost values of Hb,PLT,FIB in MTP group were significantly lower than those in n-MTP group( P<0. 05). The rate of uterus resection of MTP group is significantly lower than that of n-MTP group( P<0. 05). The rate of blood transfusion complications of MTP group is not significantly difference than that of n-MTP group( P >0. 05). The costs of massive transfusion of MTP group were not significantly difference than those of n-MTP group( P>0. 05). Conclusion: MTP blends the early and aggressive multidisciplinary intervention,not only can be quick and effective to save the pernicious placenta previa patients and improve the success rate of rescue without increasing the massive transfusion costs,but also can be helpful to keep the patient's uterus.
出处
《现代妇产科进展》
CSCD
北大核心
2016年第6期425-428,共4页
Progress in Obstetrics and Gynecology
基金
2013年广东省适宜卫生推广技术项目
关键词
大量输血方案
凶险型前置胎盘
产后大出血
Massive transfusion protocol
Pernicious placenta previa
Postpartum hemorrhage
