脐带血自体回输在产时手术及新生儿外科手术中应用的可行性探讨

Feasibility of application of umbilical cord blood autologous transfusion in intrapartum and neonatal surgery

目的探讨脐带血自体回输在产时手术及新生儿外科手术中应用的可行性。方法选取2008年8月至2018年12月在中国医科大学附属盛京医院诊断且已行产时或新生儿手术治疗并留取脐带血用于自体回输的出生缺陷病例15例。对留取的脐带血与患儿输血前外周血进行常规生化检测,对回输自体血的术后婴儿进行随访,检测血常规及其他相关术后指标,如住院天数、静脉营养支持时间等。结果胎儿自体脐带血与新生儿输血前外周血血常规结果比较,两者红细胞数[(4.15±0.35)×10^(12)/L,(4.39±0.31)×10^(12)/L,P=0.069],红细胞压积[0.4749±0.047,0.5072±0.0367,P=0.052],血红蛋白[(156.67±13.28)g/L,(166.47±13.73)g/L,P=0.065]及血小板数[(226.13±39.84)×10^(12)/L,(211.40±49.22)×10^(12)/L,P=0.391]差异无统计学意义。输注脐带血患儿术后均无输血不良反应,输血后血红蛋白达到预定指标,均未进行二次输血。结论自体脐带血血常规指标与新生儿外周血指标基本相同,并且简单易得,避免了异体成人血输血不良反应,未见不良预后,可用于新生儿手术备血输血用。

Objective To investigate the feasibility of the application of autologous umbilical cord blood transfusion in intrapartum neonatal surgery.Methods From August 2008 to December 2018,15 cases of birth defects diagnosed in Shengjing Hospital affiliated to China Medical University who had received prenatal or neonatal surgery and had cord blood retained for autologous transfusion were selected.Routine biochemical tests were performed on the retained cord blood and the peripheral blood of the children before transfusion,follow-up was conducted on the postoperative infants with autologous blood transfusion,and blood routine tests and other relevant postoperative indicators,such as length of hospital stay and duration of intravenous nutrition support,were tested.Results Comparing the routine blood test of umbilical cord blood of the fetuses with that of the peripheral blood of neonates,there was no obvious statistical difference in the number of red cells[(4.15 ± 0.35)× 10^12/L,(4.39 ± 0.31)× 10^12/L,P=0.069],erythrocyte deposited[0.4749±0.047,0.5072±0.0367,P=0.052],thenumberofhemoglobin[(156.67±13.28)g/L,(166.47±13.73)g/L,10^12/L,P=0.391].No adverse reactions were observed after umbilical cord blood transfusion.After transfusion,hemoglobin reached the predetermined indexes,and no second transfusion was performed.Conclusion The index of autologous umbilical cord blood is basically the same as that of neonatal peripheral blood,and it is simple,easy and cheap,which avoids the adverse reaction of allogeneic adult blood transfusion;there was no adverse prognosis.Therefore,it can be used for neonatal blood transfusion preparation.