不同自体血回输模式对新生儿及凶险性前置胎盘剖宫产产妇凝血功能的影响

Effect of different modes of autologous blood reinfusion on coagulation function of fetus and dangerous placenta previa pregnant woman undergoing cesarean section

  • 摘要:
      目的  分析不同自体血回输模式对新生儿及凶险性前置胎盘剖宫产孕妇凝血功能的影响。
      方法  将90例凶险性前置胎盘孕妇按照输血模式的不同分为回收组和稀释组,每组45例。比较2组孕妇治疗前后血液成分血小板计数(PLT)、红细胞比容(Hct)、血红蛋白(Hb)、凝血功能指标凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、血流动力学参数(心率、平均动脉压、血氧饱和度)、新生儿1 min和5 min Apgar评分及不良反应发生情况。
      结果  回收组新生儿1 min、5 min Apgar评分分别为(9.23±0.53)、(9.87±0.61)分,稀释组分别为(9.31±0.57)、(9.89±0.60)分,差异均无统计学意义(t=0.379、0.673,P=0.681、0.482)。回收组不良反应发生率为4.44%,低于稀释组的22.22%,差异有统计学意义(P < 0.05)。
      结论  自体血回收与稀释回输模式对孕妇的血液成分、凝血功能、血流动力学及新生儿生理活动的影响均较小,但自体血回收输血模式更为灵活,不良反应更少。

     

    Abstract:
      Objective  To analyze the effect of different modes of autologous blood reinfusion on coagulation function of fetus and dangerous placenta previa pregnant woman undergoing cesarean section.
      Methods  Ninety pregnant women with dangerous placenta previa were divided into dilution group (n=45) and blood recycle group (n=45). Blood compositionplatelet count (PLT), erythrocyte hematocrit (Hct), hemoglobin (Hb), blood coagulation function indexesprothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), hemodynamic indicators (heart rate, mean arterial pressure, blood oxygen saturation) of pregnant women before and after treatment, neonatal 1 min and 5min Apgar scores and adverse reactions of two groups were compared.
      Results  The 1 min and 5 min Apgar scores in the blood recyclegroup were (9.23±0.53) and (9.87±0.61), respectively, and (9.31±0.57) and (9.89±0.60) respectively, in the dilution group, but no differences were found in two groups (t=0.379, 0.673, P=0.681, 0.482). The incidence of adverse reactions in the blood recycle group was significantly lower than that in the dilution group (4.44% versus 22.22%, P < 0.05).
      Conclusion  Both hemodilutional autologous transfusion and intraoperative autotransfusion have little influence on blood composition, coagulation function, hemodynamics of pregnant women and fetal physiological activities. However, intraoperative autotransfusion mode is more flexible in use and has fewer adverse reactions.

     

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