摘要
迄今为止,产后出血仍然是全世界范围内孕产妇死亡的首要原因,输血在治疗产后出血中起着非常重要的作用,尤其是产后大出血及难治性产后出血,临床多以异体血的输注为主,自体输血很少见。由于术中回收式自体输血(IOCS)可能导致医源性羊水栓塞、同种异体免疫性溶血等,在一定程度上阻碍了其在剖宫产术中的开展。但近年随着我国高危、瘢痕子宫等孕妇增多及自体输血相关技术的提高,IOCS在剖宫产术中的临床应用逐渐增多,其有效性及安全性得到证实,不仅可以减少异体输血,防止异体输血的并发症与不良反应发生,某种程度上也解决了血液资源稀缺问题,同时减轻了产妇及社会经济负担,降低妊娠不良结局发生率,甚至挽救产妇生命。现对剖宫产术中血液回收和回输有关问题及临床应用进行综述。
Postpartum hemorrhage is still the leading cause of maternal mortality worldwide so far. Blood transfusion plays a very important role in the treatment of postpartum hemorrhage, especially massive postpartum hemorrhage and intractable postpartum hemorrhage. In clinical practice, allogeneic blood transfusion is the main method, while autologous blood transfusion is rare. The intraoperative cell salvage (IOCS) may lead to iatrogenic amniotic fluid embolism, allogeneic hemolysis and so on, which, to some extent, has hindered the development of IOCS in cesarean section. However, in recent years, with the increase of pregnant women with high risk, scar uterus and so on and the improvement of autotransfusion related technologies, the clinical application of IOCS in cesarean section has gradually increased, and its effectiveness and safety have been confirmed. It can not only reduce allogeneic blood transfusion, avoid its related complications and adverse reactions, but also solve the problem of scarcity of blood resources to some extent, at the same time reduce maternal and social economic burden, reduce the occurrence of adverse pregnancy outcomes, and even save maternal life. This article reviews the problems and clinical applications of blood salvage and blood doping in cesarean section.
作者
朱露
于红(审校)
ZHU Lu;YU Hong(Medical School of Southeast University,Nanjing 210009,China;Department of Obstetrics and Gynecology Southeast University Affiliated Zhongda Hospital,Nanjing 210009,China)
出处
《国际妇产科学杂志》
CAS
2019年第6期636-640,共5页
Journal of International Obstetrics and Gynecology
关键词
产后出血
失血
手术
剖宫产术
手术血液回收
输血
自体
Postpartum hemorrhage
Blood loss, surgical
Cesarean section
Operative blood salvage
Blood transfusion, autologous
