摘要
目的:探讨前置胎盘孕妇为避免自体血浪费及输注异体血的术前自体血推荐储存量。方法:收集2016年4月-2020年7月于本院行剖宫产术的120例前置胎盘孕妇的临床资料,根据术前自体储血量分为300 mL组、600 mL组、900 mL组。比较三组各阶段Hb水平及手术相关指标,通过ROC曲线评估术前自体备血量对是否输异体血的诊断性能。结果:三组采血前Hb水平、手术时间、术中失血量和住院天数比较,差异均无统计学意义(P>0.05)。最后1次采血后、术前24 h,900 mL组的Hb水平均显著低于300 mL组和600 mL组(P<0.05),300 mL组和600 mL组的Hb水平比较,差异均无统计学意义(P>0.05)。术后24 h、出院前24 h,300 mL组的Hb水平均显著低于600 mL组和900 mL组(P<0.05),300 mL组的异体输血率显著高于600 mL组和900 mL组(P<0.05)。三组自体血浪费率比较,900 mL组>600 mL组>300 mL组,组间两两比较差异均有统计学意义(P<0.05)。ROC分析显示,在截断点为450 mL时,灵敏度为73.10%,特异度为88.00%,曲线下面积为0.812(P<0.05)。结论:前置胎盘孕妇术前自体血的推荐储存量可能为450 mL,可避免自体血浪费和输注异体血。
Objective:To explore the recommended storage amount of autologous blood before operation for pregnant women with placenta previa to avoid wasting autologous blood and transfusion of allogeneic.Method:Clinical data of 120 pregnant women with placenta previa who underwent cesarean section in our hospital from April 2016 to July 2020 were collected,they were divided into three groups according to the preoperative autologous blood storage volume:300 mL group,600 mL group and 900 mL group.Hb levels and operation-related indexes among three groups were compared,and the diagnostic performance of autologous blood preparation before operation for allogeneic blood transfusion was evaluated by ROC curve.Result:Before blood collection,there were no significant differences in Hb level,operation time,blood loss during operation and hospitalization days among the three groups(P>0.05).After the last blood collection and 24 h before operation,Hb levels of 900 mL group were significantly lower than those of 300 mL group and 600 mL group(P<0.05),and there was no significant differences between 300 mLgroup and 600 mL group(P>0.05).At 24 h after operation and 24 h before discharge,Hb levels of 300 mL group were significantly lower than those of 600 mL group and 900 mL group(P<0.05),while the allogeneic blood transfusion rate of 300 mL group was significantly higher than those of 600 mL group and 900 mL group(P<0.05).The waste rate of autologous blood among three groups was compared with that in 900 mL group>600 mL group>300 mL group,pairwise comparison between groups showed statistically significant differences for every two groups(P<0.05).ROC analysis showed that the sensitivity was 73.10%,the specificity was 88.00%,and the area under the curve was 0.812(P<0.05).Conclusion:The recommended amount of autologous blood for pregnant women with placenta previa before operation may be 450 mL,which can avoid wasting autologous blood and transfusion of allogeneic blood.
作者
解绪红
严志强
杨芬莲
陈航华
张栋武
XIE Xuhong;YAN Zhiqiang;YANG Fenlian;CHEN Hanghua;ZHANG Dongwu(Foshan Gaoming Hospital Affiliated to Guangdong Medical University,Foshan 528500,China;不详)
出处
《中国医学创新》
CAS
2020年第35期1-5,共5页
Medical Innovation of China
基金
2018年佛山市医学类科技攻关项目(2018AB001664)。
关键词
前置胎盘
剖宫产术
预存式自体输血
Placenta previa
Cesarean section
Preoperative autologous blood donation
