白细胞滤器联合血液回收机用于产科自体血回收的研究进展

Research progress on leucocyte depletion filters and combined cell preservation used in obstetric cell salvage

术中自体血回收(intraoperative cell salvage,IOCS)一直以来由于白细胞污染、羊水栓塞的风险、胎儿红细胞引起的母体同种异体免疫反应等顾虑在产科中的应用受到一定的限制,近年来随着白细胞滤器(leucocyte depletion filters,LDF)的应用,其在产科得到了很好的开展。LDF为膜状结构,可滤除产科回收血中的杂质及污染物,如:胎儿鳞状上皮细胞、组织因子、甲胎蛋白、板层小体等羊水成分以及白细胞、胎儿红细胞、细菌等。但同时亦存在相关并发症,应防止加压,谨慎使用。临床上应对LDF应用于产科的安全性进行深入的研究。

The usage of intraoperative cell salvage in obstetric has been limited for the consideration of pollution of white cell, amniotic fluid embolism, allograft immune response of mother by fetal red cell, while it gets promotion because of its application as leucocyte depletion filters. Leucocyte depletion filter is a membrane structure. It can filtrate the impurities and pollutants of recvcling blood in obstetric surgery, such as amniotic fluid composition which contains fetal squamous epithelial cells, tissue factor, alpha fetoprotein, lamellar corpuscle, white cell, fetal red cell, bacteria,.., etc. This technique needs to be meticulous and cannot be pressured. Further clinical study is necessary to verify the security of leucocyte depletion filters in obstetric cell salvage.