自体血回输在宫外孕破裂出血术中的应用

Autologous blood transfusion used in operation in ruptured ectopic pregnancy

目的探讨自体血回输在宫外孕破裂出血术中应用的临床意义、安全性和效果。方法将本院20cr7年3月-2009年6月间诊断为宫外孕破裂出血行手术治疗的395名患者中腹腔出血量〉500mL的92例作对照组，以2010年3月-2012年6月间诊断为官外孕破裂出血行手术治疗的613名患者中术中出血量〉500mL的126例作为观察组。观察组术中自体血回输。观察记录2组患者术中出血量，白体血回输量，异体血用量，检测术前（T0）、输血结束后1h（T1）血红蛋白浓度（Hb）、凝血功能、Ph。结果与对照组比较，观察组术中异体输血比例（13．5％）及手术患者人均异体输血量（50±36mL）明显减少（P〈0．05），术后血红能障碍情况。结论宫外孕破裂出血术中采用自体血回输能及时提供血源，明显减少异体血用量，安全有效。蛋白浓度（102．2±9．3g／L）高于对照组（P〈0．05），2组患者的凝血功能指标有延长（P〈0．05），但P1t无明显变化。

Objective To invettigate the clinical significance of autologous blood transfusion, safety operation and effect of rupture hemorrhage in ectopic pregnancy. Methods The hospital in 2007 March to 2009 June for the diagnosis of hemorrhage of operation treatment of 395 cases of abdominal bleeding volume in patients with 500 mL in 92 cases as control group of ruptured ectopic pregnancy： In 2010 March to 2012 June for the diagnosis of ectopic pregnancy rupture as the ob- servation group hemorrhage underwent operation treatment of 613 cases of patients with more than 500 mL in 126 cases. The observation group for autologous blood transfusion in the operation of, observe and record the amount of bleeding in two groups of patients in operation, autologous blood transfusion amount, the amount of allogeneic blood, detection before opera- tion （ To ）, after blood transfusion 1 h （ T1 ）, the concentration of hemoglobin （Hb）, coagulation function, platelet. Results Compared with the control group ,the observation group the proportion of patients with aUogeneic blood transfusion and oper- ation average homologous blood transfusion in operation significantly reduced（ P 〈 0. 05 ）, hemoglobin concentration higher than that of the control group after operation （ P 〈 0. 05 ）, blood coagulation indexes of two groups of patients with prolonged （ P 〈 0. 05 ）, but no significant changes in platelet count （ P 〉 0. 05 ）, all patients were not found in the operation process of coagulation dysfunction. Conclusion Ruptured ectopic pregnancy operation, the autologous blood transfusion,timely provi- sion of blood, reducing homologous blood volume, safe and effective.