不同输血方式对输卵管妊娠破裂患者术后康复的影响及护理

Effect of postoperative rehabilitation and nursing about different ways of blood transfusion in patients with tubal pregnancy rupture

目的观察自体输血和异体输血方式对输卵管妊娠破裂患者术后康复的影响。方法选择2011年6月～2013年6月浙江省乐清市第二人民医院收治的输卵管妊娠破裂患者52例，随机分为回输组26例和库血组26例。观察两组间血压、失血量、输血量、切皮后开始输血时间及红细胞计数（RBC）、血红蛋白（HGB）、血小板（PLT）等各项指标的变化，术后比较两组之间体温，下床活动时间、肛门排气时间、切口愈合时间、拆线及住院时间的差异。结果④回输组平均失血量为（1547±427）mL，库血组平均失血量为（1489±396）mL，差异无统计学意义（P〉0．05）。术中回输组平均输血量为（1489±396）mL，库血组平均输血量为（489±167）mL，差异有统计学意义（P〈0．05）。回输组切皮后开始输血时间平均为（15．3±4．9）min，库血组平均为（19．8±6．9）min，差异有统计学意义（P〈0．05）。回输组手术开始0．5h后平均收缩压（107．3±17．6）mmHg（1mmHg=0．133kPa），平均舒张压（64．89±7．10）mmHg，库血组手术开始0．5h后平均收缩压（97．3±16．9）mmHg，平均舒张压（60．1±9．1）mmHg，差异均有统计学意义（均P〈0．05）。②术后1d两组问RBC、HGB、PLT比较，差异均无统计学意义（P〉0．05）。术后两组切口愈合、住院时间比较，差异无统计学意义（P〉0．05）；术后两组体温、下床活动时问、肠道排气时问、切口拆线时间组间比较，差异均有统计学意义（均P〈0．05）。结论自体血回输开始用血准备时间短，提高了抗休克疗效，有利于患者术后康复，在输卵管妊娠破裂中的应用和护理值得推广。

Objective To observe the effect of postoperative rehabilitation and nursing about autologous transfusion and homologous transfusion in patients with tubal pregnancy rupture. Methods 52 cases of tubal pregnancy rupture in the Second People＇s Hospital of Yueqing City from June 2011 to June 2013 were selected and divided into autologous transfusion group and homologous transfusion group with 26 cases in each group. The blood pressure, hemorrhage vol- ume, blood transfusion volume, blood transfusion time after skin incision and RBC, HGB, PLT were observed between the two groups; body temperature, bed activity time, anus exhaust time, incision healing time, stitches removing time, hospital stays between the two groups after the operation were compared. Results ①The hemorrhage volume of autolo- gous transfusion group were （1547±427） mL, hemorrhage volume of homologous transfusion group were （1489±396） mL, the difference was not statistically significant （P 〉 0.05）. The blood transfusion volume of autologous transfusion group were （1489±396） mL, the blood transfusion volume of homologous transfusion group were（489±167） mL, the difference was statistically significant （P 〈 0.05）. The blood transfusion time after skin incision of autologous transfusion group were （15.3±4.9） rain, blood transfusion time after skin incision of homologous transfusion group were （19.8±6.9） min, the difference was statistically significant （P 〈 0.05）. The systolic blood pressure and diastolic blood pressure 0.5 hour after the beginning of operation of autologous transfusion group were （107.3±17.6）, （64.89±7.10） mm Hg （1 mm Hg=0.133 kPa） respectively, the systolic blood pressure and diastolic blood pressure 0.5 hour after the beginning of operation of homol- ogous transfusion group were （97.3±16.9） mm Hg, （60.1±9.1） mm Hg respectively, the differences were statistically sig- nificant （all P 〈 0.05）. ②The differences of RBC, HGB, PLT between the two groups 1 day after the operation were not statistically significant （P 〉 0.05）. The differences of incision healing time, hospital stays between the two groups after the operation were not statistically significant （P 〉 0.05）. The differences of body temperature, bed activity time, anus exhaust time between the two groups were statistically significant （all P 〈 0.05）. Conclusion With short preparation time, autologous blood transfusion enhance the effect of anti-shock, and has benefit of postoperative rehabilitation, it is worthy of application in tubal pregnancy rupture and promotion in nursing.