剖宫产术中大出血产妇应用自体回收式输血对其血流动力学和肝、肾指标水平的影响

Effect of Autologous Blood Transfusion on Hemodynamics and Liver and Kidney Index Levels in Women with Massive Hemorrhage during Cesarean Section

目的:研究剖宫产术中大出血产妇应用自体回收式输血对其血流动力学和肝、肾指标水平的影响。方法:选取2016年12月-2018年12月在本院行自体回收式输血的剖宫产中大出血的产妇30例,和同期在剖宫产过程中大出血采用异体输血的产妇30例。对比两组术后24 h发热率、输血反应率、出血量、需异体红细胞混悬液的例数、住院时间及手术前后血常规、凝血功能、肝功能、肾功能情况。结果:两组术后24 h发热率、输血反应率、出血量及住院时间对比,差异均无统计学意义(P>0.05)。试验组需异体红细胞混悬液的例数明显少于对照组(P<0.05)。两组术后红细胞比积(HCT)、红细胞计数(RBC)、血红蛋白浓度(HGB)、血小板计数(PLT)均低于术前(P<0.05),两组术后上述指标比较,差异均无统计学意义(P>0.05)。两组术后活化部分凝血活酶(APTT)、凝血酶原时间(PT)均长于术前,纤维蛋白原(FIB)水平均低于术前(P<0.05),两组术后上述指标比较,差异均无统计学意义(P>0.05)。两组术后天冬氨酸转氨酶(AST)、谷丙转氨酶(ALT)、肌酐(Cr)、尿素氮(BUN)与术前相比,差异均无统计学意义(P>0.05),且两组术后上述指标比较,差异均无统计学意义(P>0.05)。结论:在剖宫产术中大出血中应用自体回收式输血安全有效,能够有效节约用血量,且产妇的肝肾功能及凝血功能未受到影响,值得临床推广应用。

Objective:To study the effect of autologous blood transfusion on hemodynamics and liver and kidney indexes of women with severe hemorrhage during cesarean section.Method:30 women were selected with major hemorrhage in cesarean section who underwent self-recovery transfusion in our hospital from December 2016 to December 2018,and another 30 women who underwent allogeneic blood transfusion during cesarean section were selected at the same time.The fever rate 24 h after operation,transfusion response rate,blood loss,the number of cases requiring allogeneic red blood cell suspension,hospital stay,blood routine,coagulation function,liver function and renal function before and after operation were compared between the two groups.Result:There were no significant differences in 24 h fever rate,transfusion response rate,bleeding volume and length of hospital stay between the two groups(P>0.05).The number of allogeneic red blood cell suspensions in the experimental group was significantly less than that in the control group(P<0.05).The postoperative hematocrit(HCT),red blood cell count(RBC),hemoglobin concentration(HGB),and platelet count(PLT)were lower in the two groups than those in the preoperative(P<0.05),comparison of the above indicators between the two groups after surgery showed no statistically significant differences(P>0.05).The postoperative activated partial thromboplastin(APTT)and prothrombin time(PT)were longer than those before surgery,and the fibrinogen(FIB)level was lower than that preoperative(P<0.05),there were no significant differences in the above indexes between the two groups after surgery(P>0.05).Aspartate aminotransferase(AST),alanine aminotransferase(ALT),creatinine(Cr),urea nitrogen(BUN)were not significantly different between the two groups after surgery(P>0.05),and the two groups after the comparison of the above indicators,the differences were not statistically significant(P>0.05).Conclusion:It is safe and effective to apply self-recovery type blood transfusion in massive bleeding during cesarean section,which can effectively save blood consumption,and the liver and kidney function and coagulation function of puerpera have not been affected,so it is worthy of clinical promotion and application.