摘要
目的 探讨术中回收式自体输血用于剖宫产术患者的安全性和有效性。方法选取25例剖宫产术中大出血风险较大的患者,术中实施回收式自体输血,记录术中出血量、自体血回收量及回输量、异体红细胞输注量、其他血液制品使用情况和围术期并发症发生情况,分析手术前后血红蛋白水平、凝血功能和电解质。结果(1)手术失血量1000(500,8000)mL,自体血回收量1000(300,7000)mL,自体血回输量500(250,3000)mL,80%患者无须输注异体红细胞。(2)无羊水栓塞、发热、溶血、感染等输血严重不良反应和手术并发症发生。(3)术后24h血红蛋白较术前下降,出院时与术前比较差异无统计学意义(P>0.05);术后24h的凝血酶原时间较术前及出院时延长(P<0.05),术后24h活化部分凝血活酶时间较出院时延长(P<0.05),术后24h、出院时血浆纤维蛋白原较术前延长(P<0.05)。(4)与入手术室和出手术室时相比,术后24h血钙升高(P<0.05),但血钾、血钠差异无统计学意义(P>0.05)。结论回收式自体输血用于剖宫产术患者安全且有效。
Objective To explore the safety and efficiency of intraoperative cell salvage(ICS) applied to patients undergoing cesarean section. Methods Twenty-five patients at high risk of massive blood loss during cesarean section were enrolled and received intraoperative ICS,intraoperative blood loss,volumes of autologous blood recovered and reinfused, volume of allogeneic RBC transfused,other blood products use,and incidence of perioperative complications were recorded, pre- and postoperative hemoglobin levels,coagulation function,and electrolyte were analyzed. Results (1)Blood loss amounted to 1 000(500,8 000)mL,autologous blood recovered amounted to 1 000(300,7 000)mL,autologous blood reinfused amounted to 500(250,3 000)mL,80% of the patients did not need allogeneic RBC transfusion.(2)No amniotic fluid embolism,fever,hemolysis,infection,or other serious adverse reactions,as well as operation-related complications, occurred .(3)Hemoglobin exhibited a decline at hour 24 postoperatively and showed no statistically significant difference at discharge as compared with the preoperative( P >0.05);prothrombin time at hour 24 postoperatively was prolonged than that before operation or at discharge( P <0.05),activated partial thromboplastin time at hour 24 postoperatively was prolonged than that at discharge( P <0.05), plasma fibrinogen at hour 2 postoperatively, or at discharge,was prolonged as compared with the preoperative( P <0.05).(4)Blood calcium at hour 24 postoperatively was elevated than that at the moment of entering or leaving the operating room( P <0.05),however,there was no statistically significant difference in blood potassium or sodium( P >0.05). Conclusion Cell salvage is safe and effective for patients undergoing cesarean section.
作者
卢可健
冉雪莲
黄燕娟
王彩珊
黄建春
钟日胜
黄华庚
秦东全
LU Ke-jian;RAN Xue-lian;HUANG Yan-juan;WANG Cai-shan;HUANG Jian-chun;ZHONG Ri-sheng;HUANG Hua-geng;QIN Dong-quan(Department of Anesthesiology,the Third Affiliated Hospital of Guangxi Medical University,Nanning 530031,China;Department of Obstetrics,the Third Affiliated Hospital of Guangxi Medical University,Nanning 530031,China)
出处
《广西医学》
CAS
2019年第9期1101-1104,共4页
Guangxi Medical Journal
基金
广西南宁市科学研究与技术开发计划(南科20183037-3)
