胎盘植入性疾病严重产后出血患者的输血治疗

Transfusion in severe postpartum hemorrhage patients with placenta accrete spectrum disorders

目的:分析胎盘植入性疾病患者严重产后出血大量输血情况,为产后大出血大量输血策略的制定及建立胎盘植入性疾病不良围产结局风险预测量化模型提供依据。方法回顾分析57例胎盘植入性疾病合并严重产后出血患者的临床资料,包括患者一般情况、产后出血情况、血液制品使用及血液检测指标变化情况。结果57例患者的平均出血量为(2777.19±1265.48)ml,平均输注红细胞悬液(11.46±3.23)U,55例患者同时输注新鲜冰冻血浆,23例患者同时输注血小板,10例患者输注冷沉淀,术后24h凝血功能稳定。结论大量输血治疗是胎盘植入性疾病严重产后出血的重要救治手段。血液制品合理使用及临床多学科合作有利于改善患者预后。

Objective:To analyze massive transfusion in severe postpartum hemorrhage patients with placenta accrete spectrum disorders.To provide the basis for the development of massive transfusion strategy for postpartum hemorrhage and the establishment of a quantitative model for predicting the adverse perinatal outcomes of placenta accrete spectrum disorders.Methods:57 patients with placenta accrete spectrum disorders and severe postpartum hemorrhage were retrospectively analyzed,including patients'characteristics,postpartum hemorrhage,blood component usage,and blood indicators.Results:The average blood loss of 57 patients was(2777.19±1265.48)ml,and the average infusion of red blood cell suspension was(11.46±3.23)U.55 patients were simultaneously transfused with fresh frozen plasma.Platelets and cryoprecipitate were used in 23 and 11 patients,respectively.The coagulation function was stable in 24 hours postoperation.Conclusion:Massive transfusion is an essential therapeutics for severe postpartum hemorrhage in placenta accrete spectrum disorders.Use of blood components and clinical multidisciplinary cooperation will help to improve patient prognosis.