回收式自体输血在异位妊娠手术中的应用

Application of Autologous Reclaimed Blood Transfusion for Intraabdominal Hemorrhage Due to Ectopic Pregnancy

【目的】探讨在异位妊娠所致腹腔内出血的手术中进行回收式自体输血的安全性和临床效果。【方法】对手术证实为异位妊娠所致的腹腔内出血,且无回输式自体输血禁忌证患者96例,采用自体型血液回收机,经过抗凝、回收、洗涤、浓缩、净化处理后回输给患者;将其中仅靠自体输血完成手术的78例作为自体输血组(A组),其余18例因同时给予异体输血作为自体+异体输血组(B组),并将同时期异位妊娠采用同种异体输血的27例作为异体输血组(C组)。对三组患者自体及异体输血量、发热及输血反应情况、术后24h血常规及电解质情况做观察比较。【结果】A、B组平均输血量(异体输血与自体输血之和)虽高于C组,但异体输血量明显降低,三组比较,术后发热和输血反应A、B组较C组明显减少。而三组患者术后24h血常规及电解质情况比较差异无显著性。【结论】回收式自体输血既节约了大量血源,又减少了输血后并发症,是抢救和治疗急性腹腔内出血安全有效的方法。

[Objective]To evaluate the safety and efficacy of intraoperative autologous reclaimed blood transfusion for intraabdominal hemorrhage due to ectopic pregnancy. [Methods]Ninety six cases of women with ectopic pregnancy undergone operation were adopted the intraoperative autologous reclaimed blood transfusion without contraindication. The blood was transfused back to the patients after collection, anticoagulation, rinsings, condensation and purification. Among them, 78 cases were given autologous reclaimed blood transfusion alone（Group A）, 18 cases were given allogeneic blood transfusion as well（Group B）. At the same time, 27 cases with ectopic pregnancy were given allogeneic blood transfusion alone as control（Group C）. The transfusion amount, fever, reactions to the transfusion and blood routine, electrolyte were compared 24 hours after the operation. [Results]Though the average transfusion amount was higher in groups A and B than in group C, the amount of allogeneic blood transfusion was reduced significantly. The number of fever and reactions to the transfusion after the operation in group A was less than in group C. However, no significant difference was found in the blood routine and electrolyte among the three groups. [Conclusion]Autologous reclaimed blood transfusion is safe and effective for intraabdominal hemorrhage due to ectopic pregnancy.