术中回收式自体输血在产科患者中的应用

Application of intraoperative cell salvage in obstetric patients

术中回收式自体输血(IOCS)不仅避免输血相关风险,减少血液浪费,且方便、快速,节省开支,其在围手术期的应用越来越受到重视。由于担心羊水栓塞及同种免疫反应发生,IOCS在产科的应用存在较大争议。已有研究证实加用白细胞滤器可有效滤过回收血液中的羊水成分,增加安全性,且抗-D免疫球蛋白也可阻止同种免疫反应的发生。目前欧美国家已将IOCS作为成功挽救妊娠妇女生命的应急措施,并未出现严重不良反应报道。本文将IOCS在产科患者的应用做一综述。

Intraoperative cell salvage（ IOCS） is becoming more and more important as a strategy to decrease the need for allogeneic blood transfusion and to avoid the risk of blood transfusion. Traditionally,IOCS has been avoided in obstetric population because of the perceived risk of amniotic fluid embolism or induction of alloimmunization. Studies confirmed that the addition of leukocyte filter can effectively remove the amniotic fluid components in post-washed blood,and anti-D immunoglobulin can also prevent the occurrence of alloimmunization. The risks of IOCS in the obstetric population parallel those in the general population. At present,European and American countries use IOCS as an emergency measure to rescue pregnant women＇s lives. No definite cases of adverse reaction have been reported. We will review the application of IOCS in obstetric patients.