自体血液回收在宫外孕手术中的应用

Exploratory development of interaoperation autologous reclaimed blood on transfusion of ectopic pregnancy

目的 探讨自体血液回收在宫外孕手术中的安全性、有效性和临床疗效。方法 选择46例宫外孕病人进行自体血液回收，经过滤、离心、清洗后回输给病人。监测循环、血常规、凝血功能、电解质、血浆蛋白的变化；观察回收血量、回输血量，尿液颜色和伤口渗出情况。结果回输后心率降低，平均动脉压（MAP）升高（P〈0．01）；血红蛋白（Hb）和血细胞比容（Hct）回输后均显著升高（P〈0．01）；回输前后凝血酶原时间（胛）和部分凝血活酶时间（APTT）无明显变化（P〉0．05）；在回输后24h，K^＋和Ca^2＋升高有统计学意义（P〈0.05），Na^＋和Clˉ无明显变化；总蛋白（TP）、白蛋白（ALB）和前白蛋白（PA）回输前降低，回输后无明显变化（P〉0．05）。平均回收血液（2075±441）ml。回输（1019±287）ml。无肉眼血红蛋白尿，伤口愈合良好。结论 自体血液回收技术用于临床安全可靠，节约血源，减少异体输血。

Objective To study the safety and efficacy and therapeutic effect of interaoperation autologous reclaimed blood on transfusion of ectopic pregnancy. Methods Forty - six patients ectopic pregnancy were selected, using blood recover system. The blood was collected from intraoperative, and transfused back to the patients after filtration and centrifuge and cleaing, The circulaton, routine, color, electrolyte and albumen were measured before hemorrhage and intraoperation as well as after being infused with the blood, The blood of callback and transfusion, the color of urine and the effusion of wound were observed. Results Heart rate decreased and mean arterial pressure increased significantly after blood infusion（ P 〈 0.01 ）. Hb and Hct increased significantly after blood infusion （ P 〈 0.01 ）. PT and APTT had few changes （ P 〉 0.05 ）. K ^＋ and Ca^2＋ changed significantly after blood infusion 24 hours （ P 〈 0.05 ）. Na^＋ and Clˉhad few changes, TP, ALB and PA had lower before transfusion, but they were normal. （ P 〈 0.05 ）. （2075 ±441 ） ml blood was collected per patient during operation and （ 1019 ± 287 ） ml blood was infused into the patients, without blood urine and the wound was healed. Conclusion It is safe and effective and saving blood, that technique of intraoperative autologous reclaimed blood on transfusion of ectopic pregnancy.