前置胎盘患者预存式自体输血安全性研究

Preoperative autologuous blood donation in placenta previa patients

目的研究预存式自体输血对前置胎盘患者红细胞、血红蛋白、细胞比容和血小板数量的影响,并观察产后出血以及妊娠结局,进而探讨在前置胎盘患者中实施预存式自体输血的安全性,为以后临床操作提供参考。方法收集2004—2007年5月住院分娩的64名前置胎盘患者,将其分为预存式自体输血组和未自体输血组。比较自体输血患者采血前后不同时间以及两组分娩前后红细胞、血红蛋白、细胞比容和血小板数量差异有无显著性。观察不同组产后出血量、自异体输血量和妊娠结局。结果预存式自体输血患者采血前、采血后24—72h及分娩后48h和两组分娩前后血常规主要指标差异不具统计学意义(P>0.05)。实施过程对母胎不会产生不良影响,新生儿Apgar评分9—10分。自体输血组的自血回输量明显大于异体输血量。结论预存式自体输血对前置胎盘患者红细胞、血红蛋白、细胞比容和血小板数量不会产生明显的影响,且对母胎安全不会造成威胁。实际操作中可适当增加分娩前预存式自体备血量以减少前置胎盘患者剖宫产异体输血量。

Objective To study the influence of preoperative autologous blood donation （PABD） on peripheral blood counts of red blood cells, hemoglobin and platelets in patients with placenta previa, and to observe the volume of postpartum hemorrhage and pregnancy outcome. Methods Sixty-four placenta previa cases from 2004 to May 2007 were included in the study and were divided into two groups ： PABD group and the control group. The changes of the peripheral blood counts, such as red blood cells, hemoglobin, hematocrit, and platelets, in the PABD group before and after blood collection were analyzed retrospectively. The preoperative and postoperative blood cell counts, postpartum hemorrhage volume, autotransfusion volume and pregnancy Outcomes were compared between the two groups. Results There was no significant difference in the peripheral blood counts in PABD group before, 24-72 hours after blood collection, and 48-hour after delivery. The peri-and pest-operative blood cell counts were not different between the PABD and the control groups. The performance of PABD is harmless to mothers and fetuses, and the Apgar score of the newborns was 9-10. In PABD group, the volume of autologous blood transfusion was significantly larger than that of homologous blood transfusion. Conclusion The performance of PABD didn＇t affect the blood cell counts of patients with placenta previa, and it＇s harmless to the mother and the fetus. PABD before cesarean section can be performed to reduce the volume of homologous blood transfusion.