两种自体输血方式在中央性前置胎盘孕妇中应用的安全性分析

目的探讨储存式自体输血和急性等容稀释式自体输血在中央性前置胎盘孕妇剖宫产术中应用的安全性及临床疗效。方法选择2013年1月至2016年9月在我院因中央性前置胎盘拟行剖宫产术的60例患者为研究对象。采用随机数字表的方法平均分为两组:A组为储存式自体输血组,B组为急性等容稀释式自体输血组。观察两组患者自体输血采血前后及手术后的血红蛋白(Hb)、血细胞比容(Hct)、血小板计数(PLT)、术中出血量、输血量、新生儿Apgar评分及Hb水平、输血不良反应等。结果两组患者出血量及输血量比较无显著性差异(P0.05)。两组患者采血前后及手术后的Hb、Hct、PLT比较亦无显著性差异(P0.05)。两组新生儿1分钟Apgar评分及Hb水平比较无显著性差异(P0.05)。两组患者中输注自体血的患者均未发生输血不良反应,术后恢复良好;输注异体血的患者中,B组仅有1例出现发热、皮疹,未出现严重不良反应。结论储存式自体输血和急性等容稀释性自体输血在应用安全性上无明显差异。在基层医院临床工作中,针对中央性前置胎盘患者,由于剖宫产输血率高,可以在综合评估患者具体情况后,对必要的患者选择自体输血。

Safety analysis of two kinds of autologous blood transfusion in patients with central placenta previa

Objective:To compare the safety and clinical efficacy between stored autologous blood transfusion and acute normovolemic hemodilution (ANHD) autologous blood transfusion during cesarean section in the pregnant women with central placenta previa.Methods:Sixty patients with central placenta placenta in our hospital from January 2013 to September 2016 were included in the study.The patients were divided into two groups according to the method of autologous blood transfusion:the patients with storage autotransfusion in group A (n=30),and the patients with acute normovolemic hemodilution autotransfusion in group B (n=30).Hemoglobin (Hb) level,hematocrit (Hct),platelet count (PLT) before and after blood collection,and after intraoperative bleeding;the amount of blood transfusion,neonatal Apgar score at 1 min,neonatal hemoglobin (HB) level,and adverse reactions to blood transfusion were compared between the two groups.Results:There was no significant difference in amount of blood loss or blood transfusion between the two groups (P>0.05).There were no significant differences in Hb,Hct and PLT before and after blood collection,and after operation between the two groups (P>0.05).There were no significant differences in Apgar score at 1 min.and hemoglobin (Hb) level between the two groups (P>0.05).The patients did not have adverse transfusion reactions,and had good postoperative recovery.In patients with allogeneic blood transfusion,there was only 1 patient with fever and rash,no serious adverse events in group B.Conclusions:There is no significant difference in application safety between stored autologous blood transfusion and acute normovolemic hemodilution autologous blood transfusion.In the primary hospital clinical work,autologous blood transfusion can be chosen for patients with central placenta previa after comprehensive assessment of specific circumstances due to high blood transfusion rate in cesarean section.