两种输血方式用于剖宫产术中的效果比较

Comparison of efficacy of two blood transfusion methods in cesarean delivery

目的比较自体输血与异体输血在凶险性前置胎盘产妇剖宫产术中的应用效果及并发症发生情况。方法选择义乌市中心医院2013年1月至2019年12月收治的凶险性前置胎盘行剖宫产术的产妇60例为研究对象,按照不同输血方式分为自体输血组与异体输血组,每组30例。自体输血组采用自体贮存式输血方案,异体输血组采用异体输血方案。比较两组产后出血量、异体输血量和自体输血量、术前和术后3 d血红蛋白、红细胞比容和凝血指标变化及并发症发生情况。结果自体输血组术后出血量为(9897.42±215.37)mL,少于异体输血组的(23081.87±546.23)mL(t=122.990,P<0.05);自体输血组异体输血量(954.32±143.42)mL,少于异体输血组的(10474.18±376.87)mL(t=129.310,P<0.05);自体输血组术后3 d血红蛋白(106.32±12.19)g/L、红细胞比容(0.39±0.19),均高于异体输血组[(86.18±3.25)g/L和(0.34±0.14)](t=8.744、11.633,均P<0.05);自体输血组术后3 d D-二聚体[(5.45±1.29)mg/L]和纤维蛋白原降解产物(FDP)[(13.42±2.41)mg/L]均低于异体输血组[(8.56±1.47)mg/L和(21.30±3.64)mg/L](t=8.710、9.887,均P<0.05)。自体输血组并发症发生率[6.67%(2/30)]低于异体输血组[36.67%(11/30)](χ^(2)=7.954,P<0.05)。结论自体输血用于凶险性前置胎盘剖宫产术中效果较好,且可降低输血并发症发生。

Objective To explore the application value and complications of two blood transfusion methods used for cesarean delivery.Methods Sixty parturients undergoing cesarean delivery in Yiwu Central Hospital from January 2013 to December 2019 were included in this study.They were divided into autogenic blood transfusion and allogeneic blood transfusion groups(n=30/group)according to different blood transfusion methods used.In the autogenic blood transfusion group,self-storage blood transfusion scheme was used,while in the allogeneic blood transfusion group,allogeneic blood transfusion scheme was used.The amount of postpartum blood loss,amount of autogenic blood transfused,amount of allogeneic blood transfused,hemoglobin,hematocrit and coagulation index before and 3 days after surgery,complications were compared between autogenic blood transfusion and allogeneic blood transfusion groups.Results Postoperative blood loss in the autogenic blood transfusion group was significantly less than that in the allogeneic blood transfusion group[(9897.42±215.37)mL vs.(23081.87±546.23)mL,t=122.990,P<0.05].The amount of autogenic blood transfused in the autogenic blood transfusion group was less than that in the allogenic blood transfusion group[(954.32±143.42)mL vs.(10474.18±376.87)mL,t=129.310,P<0.05).Hemoglobin level and hematocrit at 3 days after surgery in the autogenic blood transfusion group were(106.32±12.19)g/L and(0.39±0.19),which were significantly higher than those in the allogenic blood transfusion group[(86.18±3.25)g/L,0.34±0.14,t=8.744,11.633,both P<0.05].D-Dimer and fibrin degradation product levels in the autogenic blood transfusion group were(5.45±1.29)mg/L and(13.42±2.41)mg/L,respectively,which were significantly lower than those in the allogenic blood transfusion group[(8.56±1.47)mg/L,(21.30±3.64)mg/L,t=8.710,9.887,P<0.05].The incidence of complications in the autogenic blood transfusion group was significantly lower than that in the allogenic blood transfusion group[6.67%(2/30)vs.36.67%(11/30),χ^(2)=7.954,P<0.05].Conclusion Autogenic blood transfusion is highly effective for cesarean delivery of dangerous placenta previa,and it has few complications.