储存联合回收式自体输血在高出血风险剖宫产产妇中的应用效果

doi:10.3760/cma.j.cn441417-20250618-22018

摘要/Abstract

摘要： 目的　分析储存联合回收式自体输血在高出血风险剖宫产产妇中的应用效果。方法　采用回顾性分析，选取2016年10月至2024年8月于汉中市中心医院行剖宫产术的高出血风险产妇184例，按照输血方式不同分为对照组和观察组，各92例。对照组产妇年龄（32.54±4.25）岁，接受常规异体输血。观察组产妇年龄（32.21±4.66）岁，接受储存联合回收式自体输血。比较两组凝血功能［活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、纤维蛋白原（FIB）、活化凝血时间（ACT）］、白细胞计数、中性粒细胞百分比、淋巴细胞百分比、氧合状况［动脉血氧分压（PaO₂）、混合静脉血氧饱和度（SvO₂）］及不良反应发生率。采用t、χ²检验进行统计分析。结果　输血后，两组FIB水平比较差异无统计学意义（P>0.05）；观察组APTT、PT、ACT水平均低于对照组［（34.78±2.71）s比（35.83±2.14）s、（15.82±2.25）s比（16.69±2.18）s、（120.54±24.52）s比（129.32±25.23）s］，差异均有统计学意义（t=2.917、2.664、2.394，均P<0.05）。观察组白细胞计数、中性粒细胞百分比低于对照组［（9.25±1.36）×10⁹比（10.41±1.55）×10⁹、（70.28±2.57）比（72.30±2.61）］，淋巴细胞百分比高于对照组［（5.96±1.04）比（5.44±1.02）］，差异均有统计学意义（t=5.396、5.290、3.424，均P<0.05）。观察组PaO₂和SvO₂水平均高于对照组［（124.41±18.57）mmHg（1 mmHg=0.133 kPa）比（113.85±17.46）mmHg、（87.21±5.57）%比（84.13±4.32）%］，差异均有统计学意义（t=3.974、4.191，均P<0.05）。观察组和对照组不良反应发生率比较［8.70%（8/92）比14.13%（13/92）］，差异无统计学意义（P>0.05）。结论　储存联合回收式自体输血可有效改善高出血风险剖宫产产妇的凝血功能、氧合状况，减轻炎症反应，且不增加不良事件，具有较高的临床应用价值。

关键词: 剖宫产术, 高出血风险, 储存式, 回收式, 自体输血, 效果

Abstract:

Objective　To analyze the clinical effect of predeposit and intraoperative autologous blood transfusion in women with high hemorrhagic risk taking cesarean section. Methods　One hundred and eighty-four high-risk pregnant women undergoing cesarean section at Hanzhong Central Hospital between October 2016 and August 2024 were selected as the study objects. Based on the transfusion methods, the women were divided into a control group and an observation group, with 92 cases in each group. The control group were (32.54±4.25) years old, and received conventional allogeneic transfusion. The observation group were (32.21±4.66) years old, and received autologous transfusion with predeposit and intraoperative autologous blood. The coagulation parameters [activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB), and activated clotting time (ACT)], white blood cell counts, neutrophil percentages, lymphocyte percentages, oxygenation indicators [arterial oxygen partial pressure (PaO₂) and mixed venous oxygen saturation (SvO₂)], and incidence rates of adverse reactions were compared between the groups. Statistical analysis was performed using t and χ² tests. Results　After the transfusion, there was no statistical difference in the FIB level between the two groups (P>0.05); the APTT, PT, and ACT in the observation group were shorter than those in the control group [(34.78±2.71) s vs. (35.83±2.14) s, (15.82±2.25) s vs. (16.69±2.18) s, and (120.54±24.52) s vs. (129.32±25.23) s], with statistical differences (t=2.917, 2.664, and 2.394; all P<0.05). The white blood cell count and neutrophil percentage in the observation group were lower than those in the control group [(9.25±1.36)×10⁹ vs. (10.41±1.55)×10⁹ and (70.28±2.57)% vs.(72.30±2.61)%], while the lymphocyte percentage was higher [(5.96±1.04)% vs. (5.44±1.02)%], with statistical differences (t=5.396, 5.290, and 3.424; all P<0.05). Both PaO₂ and SvO₂ in the observation group were higher than those in the control group [(124.41±18.57) mmHg vs. (113.85±17.46) mmHg (1 mmHg=0.133 kPa) and (87.21±5.57)% vs. (84.13±4.32)%], with statistical differences (t=3.974 and 4.191; both P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the observation group and the control group [8.70% (8/92) vs. 14.13% (13/92); P>0.05]. Conclusion　Predeposit and intraoperative autologous blood transfusion can significantly enhance coagulation function and oxygenation status while attenuating the inflammatory response in women with high hemorrhagic risk taking cesarean section, without increasing adverse events.

Key words: Cesarean section, High hemorrhagic risk, Predeposit, Recycling, Autologous transfusion, Effect

韩莉王燕韩星. 储存联合回收式自体输血在高出血风险剖宫产产妇中的应用效果[J]. 国际医药卫生导报, 2025, 31(22): 3785-3789.

Han Li, Wang Yan, Han Xing. Clinical efficacy of predeposit and intraoperative autologous blood transfusion in women with high hemorrhagic risk taking cesarean section[J]. International Medicine and Health Guidance News, 2025, 31(22): 3785-3789.

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