回收式自体输血对剖宫产术中产后出血的应用价值

The application value of autotransfusion salvage for bleeding after cesarean section

目的研究回收式自体输血对剖宫产术中产后出血的临床疗效评价。方法选取2014年1月~2016年12月在我院行剖宫产术,以回收式自体输血211例作为研究组,未输血或异体输血292例为对照组,比较两组患者术中、术后24 h出血量,术后发热,术后24h及48h血常规、血红蛋白、血浆白蛋白等指标变化,及切口愈合情况、住院天数比较。结果研究组的年龄(31.74±5.00)岁大于对照组(30.58±4.91)岁(P<0.05),研究组术中出血量(1389±362)mL、术后24 h再出血量(294±81)mL明显多于对照组(P<0.05),且术后发热、术后24 h白细胞数及中性粒细胞的差值均少于对照组,差异有统计学意义(P<0.05)。在血液输注过程中,研究组出现过敏现象10例与对照组6例比较差异无统计学意义(P>0.05)。结论自体血回输技术保留术中失血、减少异体输血的输注,其操作简单,处理迅速,可安全有效地应用于剖宫产术中血液保护。

Objective To study the clinical effect of autotransfusion salvage on bleeding after cesarean section. Methods Patients undergoing cesarean section in our hospital from January 2014 to December 2016 were taken as the study subjects. 211 cases who applied autotransfusion salvage were enrolled into the study group, while 292 cases who applied allogeneic transfusion or had no transfusion as the control group. The changes of bleeding volume during and after operation, postoperative fever, blood routine after 24 and 48 h of operation, hemoglobin, plasma albumin and other indexes,wound healing and hospitalization stay were compared between the two groups. Results The age of the study group was(31.74±5.00) years old, which was higher than that of the control group(30.58±4.91) years old(P<0.05). The bleeding volume during operation and 24 h after operation in the study group was(1389±362) mL and(294±81) mL respectively,which was significantly higher than that in the control group(P<0.05). Postoperative fever, the amount of white blood cells and neutrophil differential value in the study group were lower than those in the control group, and the differences were statistically significant(P<0.05). In the course of blood transfusion, 10 cases developed allergy in the study group,which was more than that in the control group, and the difference was not statistically significant(P>0.05). Conclusion Autotransfusion savage is a simple, rapid and safe technique for preserving intraoperative blood loss and reducing transfusion of allogeneic transfusion.