急性等容血液稀释联合自体成分血回输在产科前置胎盘患者的应用

目的 研究急性等容血液稀释联合自体成分血回输对前置胎盘患者分娩前后RBC、Hb、HCT和PLT的影响,并观察术中出血量及出血并发症,探讨在前置胎盘患者中应用该方法的可行性和有效性.方法 选择2008年1月至12月期间在我院住院行择期剖宫产分娩的前置胎盘患者共30例,根据是否进行自体输血分为研究组和对照组,研究组患者予术前急性等容血液稀释联合术中自体成分输血,对照组不进行自体输血,观察和比较患者手术前后血液学指标（RBC、Hb、HCT和PLT）的变化、术中出血量和异体血输注情况.结果 研究组术后血中RBC、Hb、HCT均高于对照组（均P〈0.05）,但两组PLT的差异无统计学意义（P〉0.05）;研究组患者的术中出血量和Hb含量的术前术后变化均小于对照组（均P〈0.05）;研究组异体输血及子宫切除的发生率低于对照组,但差异无统计学意义（P〉0.05）.结论 等容血液稀释联合自体成分血回输可减少产科前置胎盘患者的术中出血量.

Application of acute normovolemic hemodilution combined with platelet-rich plasma sequestration for placenta previa patients

Objective To evaluate the application of acute normovolemic hemodilution （ANHD） combined with platelet-rich plasma sequestration for placenta previa patients. Methods Thirty patients of placenta previa from January 2008 to December 2008 were enrolled in the study. The patients were divided into two groups： experimental group receive ANHD with platelet-rich plasma sequestration and the control group received the conventional treatment. Peripheral blood counts were measured before and after cesarean section were recorded in both groups. Intraoperative hemorrhage volume and pregnancy outcome were recorded and compared. Results The peripheral red blood counts, hemoglobin and hematocrit in experimental group were higher than those in control group （P〈0.05）, but the platelet counts were not different between the two groups （P 〉0.05）. The intraoperative hemorrhage volume was significantly lower in experimental group than that in control group（P〈0.01）. There were no significant differences in the rate of allogeneic blood transfusion and hysterectomy between two groups （P 〉0.05）. Conclusion ANHD with platelet-rich plasma sequestration during cesarean section reduce the volume of intraoperative hemorra- hage in patients with placenta previa.