剖宫产术中回收式自体输血的适应证探讨

Indication of Intraoperative Cell Salvage in Cesarean Section

目的回顾性统计我院近年来回收式自体输血(intraoperative cell salvage,ICS)使用情况,分析剖宫产术中自体血回输的适应证。方法统计2018年1月~2019年12月我院应用ICS的剖宫产妇共1108例,根据其是否回输自体血分为回输组(673例)和未回输组(435例),分析两组产妇术前基本情况及临床资料,采用SPSS 23.0统计软件进行数据分析。结果2018年1月~2019年12月ICS回输率为60.74%。回输组产妇术中失血量与自体血回输血量呈线性相关关系。与未回输组比较,回输组产妇术中失血量、前置胎盘、胎盘植入、胎盘早剥、瘢痕子宫、子痫前期等方面存在显著差异(均P<0.05)。纳入Logistic多因素回归分析显示前置胎盘、胎盘植入、胎盘早剥和瘢痕子宫是ICS的危险因素。结论前置胎盘、胎盘植入、胎盘早剥和瘢痕子宫是自体血回输的适应证,推荐此类产妇剖宫产术中常规使用ICS。

Objective To retrospectively analyze the use of intraoperative cell salvage(ICS)in our hospital in recent years,and to analyze the indication to ICS during cesarean section.Methods A total of 1108 women with cesarean section in our hospital from January 2018 to December 2019 were included,673 cases in the reinfusion group and 435 cases in the non-reinfusion group.The basic information and clinical data between two groups were analyzed by SPSS 23.0.Results The reinfusion rates of ICS between Jan.2018 and Dec.2019 were 60.74%.In the reinfusion group,there was a linear correlation between the amount of blood lost and reinfusion during the operation.There were significant differences in placenta previa,placenta accreta,placental abruption,scarred uterus,preeclampsia and the amount of blood lost between the two groups(P<0.05).Logistic regression analysis showed that placenta previa,placental accreta,placental abruption and scarred uterus can increase the risk of autologous blood transfusion.Conclusion Placenta previa,placental accreta,placental abruption and scarred uterus are indications for autologous blood transfusion.ICS is recommended for cesarean section in these pregnant women.