术中自体血回收用于产科手术的可行性研究

Feasibility Study of Intraoperative Autologous Blood Recovery for Obstetric Surgery

目的 探究术中自体血回收用于产科手术的可行性。方法 选择六盘水市妇幼保健院产科于2021年1月—2023年12月行产科手术40例患者作为研究对象,使用随机数表法分为对照组、研究组,每组20例,依次实施术中异体输血、术中自体血回输治疗,对比两组母体输血前后的部分凝血酶原时间(Activated Partial Thromboplastin Time, APTT)、凝血酶原时间(Prothrombin Time, PT)、纤维蛋白原(Fibrinogen, Fbg-T)、凝血酶时间(Thrombin Time, TT)等凝血功能水平、平均动脉压(Mean Arterial Pressure, MAP)、心率(Heart Rate, HR)等血流动力学指标及不良反应情况。结果 输血前,两组凝血指标比较,差异无统计学意义(P>0.05);输血后,研究组的APTT(20.88±4.11)s、PT(11.08±2.20)s、TT(14.59±1.41)s均短于对照组的(34.22±4.02)s、(13.81±2.11)s、(18.06±1.58)s,研究组的Fbg-T(4.48±0.20)g/L水平高于对照组的(3.74±0.32)g/L,差异有统计学意义(t=10.377、4.005、7.328、8.770,P均<0.05)。输血前,两组血流动力学指标比较,差异无统计学意义(P>0.05);输血后,研究组的MAP(81.26±1.23)mmHg、HR(87.96±4.11)次/min均低于对照组的(86.84±2.36)mmHg、(92.28±7.23)次/min,差异有统计学意义(t=9.377、2.323,P均<0.05)。研究组发热、输血反应发生率为5.00%、0,均低于对照组的15.00%、10.00%,差异有统计学意义(χ^(2)=6.147、5.625,P均<0.05)。结论 产科手术术中自体血回输能够对患者凝血功能产生积极影响,使患者血液动力学保持稳定,且临床使用不良反应发生率较低,使用的可行性较高。

Objective To investigate the feasibility of intraoperative autologous blood recovery for obstetric surgery.Methods Forty patients who underwent obstetric surgery in the Department of Obstetrics of Liupanshui Maternal and Child Health Hospital from January 2021 to December 2023 were selected for the study,and were divided into a con-trol group and a study group using the randomized table method,with 20 cases in each group,and were treated with in-traoperative allogeneic blood transfusion and intraoperative autologous blood recovery in that order.The coagulation function levels such as activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(Fbg-T),thrombin time(TT),hemodynamic indexes such as mean arterial pressure(MAP),heart rate(HR),and adverse reac-tions before and after transfusion of blood from mothers of the two groups were compared.Results Before blood trans-fusion,there was no statistically significant difference in the coagulation indexes between the two groups(P>0.05).After blood transfusion,APTT(20.88±4.11)s,PT(11.08±2.20)s and TT(14.59±1.41)s of the study group were shorter than those of the control group,which were(34.22±4.02)s,(13.81±2.11)s and(18.06±1.58)s,The level of Fbg-T(4.48±0.20)g/L in the study group was higher than that of(3.74±0.32)g/L in the control group,and the differ-ence was statistically significant(t=10.377,4.005,7.328,8.770,all P<0.05).Before blood transfusion,there was no statistically significant difference in hemodynamic indexes between the two groups(P>0.05).After blood transfusion,the MAP(81.26±1.23)mmHg and HR(87.96±4.11)beats/min indexes of the study group were lower than those of the control group's(86.84±2.36)mmHg and(92.28±7.23)beats/min,and the differences were statistically significant(t=9.377,2.323,both P<0.05).The incidence of fever and transfusion reaction in the study group was 5.00%and 0,which were lower than 15.00%and 10.00%in the control group,and the difference was statistically significant(χ^(2)=6.147,5.625,both P<0.05).Conclusion Intraoperative autologous blood transfusion in obstetric surgery can positively affect patients'coagulation function and keep patients'hemodynamics stable,and the incidence of adverse reactions in clinical use is low,and the feasibility of use is high.