成分输血配合限制性液体复苏在异位妊娠产后大出血合并失血性休克中的应用对提升抢救成功率的效果研究

Effect of Component Blood Transfusion Combined with Restrictive Fluid Resuscitation in Postpartum Hemorrhage of Ectopic Pregnancy Combined with Hemorrhagic Shock to Improve the Success Rate of Rescue

目的分析在异位妊娠产后大出血合并失血性休克的治疗中采取成分输血配合限制性液体复苏对于抢救成功率的影响。方法随机选择重庆市綦江区人民医院2016年1月—2019年11月妇产科的74例异位妊娠产后大出血合并失血性休克患者为研究对象,根据随机数字表法划分成参照组(n=37)、观察组(n=37)。给予参照组限制性体液复苏抢救治疗,观察组同时配合成分输血治疗,评价抢救情况。结果观察组(97.30%)抢救成功率高于参照组(78.38%),差异有统计学意义(χ^(2)=4.554,P<0.05);观察组(5.40%)并发症发生率低于参照组(21.62%),差异有统计学意义(χ^(2)=4.162,P<0.05);观察组治疗2 h后的血流动力学、凝血功能优于参照组,差异有统计学意义(P<0.05);观察组总出血量、输血量以及输液量均少于参照组,差异有统计学意义(P<0.05)。结论在异位妊娠产后大出血合并失血性休克的抢救治疗中应用成分输血配合限制性液体复苏,可纠正异常的凝血功能,稳定血流动力学,有利于提高抢救成功率,减少出血量、输液量及输血量,具有较高价值。

Objective To analyze the effect of component blood transfusion combined with restrictive fluid resuscitation on the success rate of rescue in the treatment of postpartum hemorrhage in ectopic pregnancy with hemorrhagic shock.Methods Seventy-four patients with ectopic pregnancy and postpartum hemorrhage combined with hemorrhagic shock in the department of obstetrics and gynecology of Qijiang District People’s Hospital in Chongqing City from January 2016 to November 2019 were randomly selected as the research subjects,and divided into reference groups according to the random number table method(n=37),observation group(n=37).Restricted body fluid resuscitation was given to the reference group for rescue treatment,and the observation group was treated with component blood transfusion at the same time to evaluate the rescue situation.Results The rescue success rate of the observation group(97.30%)was higher than that of the reference group(78.38%),the difference was statistically significant(χ^(2)=4.554,P<0.05);the complication rate of the observation group(5.40%)was lower than that of the reference group(21.62%),the difference was statistically significant(χ^(2)=4.162,P<0.05);the hemodynamics、coagulation function and total bleeding of the observation group after 2 h treatment was better than that of the reference group,the difference was statistically significant(P<0.05);the blood transfusion volume and fluid volume of the observation group were all lower than the reference group,the difference was statistically significant(P<0.05).Conclusion In the rescue treatment of postpartum hemorrhage in ectopic pregnancy combined with hemorrhagic shock,component blood transfusion combined with restricted fluid resuscitation can correct abnormal coagulation function,stabilize hemodynamics,improve the success rate of rescue,and reduce bleeding amount of fluids,fluids and blood transfusions,with high value.