Abstract:

Objective　To explore the effect of intrauterine blood transfusion and summarize nursing experience for fetuses with maternal-fetal Rh incompatible anemia, and to improve the clinic curative effect and reduce the complications of intrauterine blood transfusion. Methods　This was a non-randomized controlled study. A total of 19 pregnant women who received intra-uterine blood transfusion treatment for fetal anemia due to maternal-fetal Rh blood group incompatibility from January 2020 to June 2022 in First Hospital Affiliated to Sun Yat-sen University were selected as the study objects by the convenience sampling method. The pregnant women were(31.39±4.13) years old. The gestational weeks were (26.34±4.71) weeks. There were 2 primiparas, 17 metaparas, 9 cases with adverse pregnancy history, and 4 cases with fetal edema. Intrauterine transfusion was given; corresponding nursing care was given before, during, and after intrauterine transfusion. The concentrations of fetal umbilical cord blood hemoglobin (Hb) and hematopoietic volumes (HCT) before and after the transfusion and the occurrence of complications after transfusion were recorded. t test was used to compare the data before and after the transfusion. Results　 The fetal umbilical cord blood Hb and HCT concentrations were significantly higher after than before the blood transfusion [(121.56±27.69) g/L (69.90±22.34) g/L and (36.87±7.84)% vs. (21.17±6.52)%], with statistical differences (t=-11.937 and -12.702, both P<0.05). One case (5.26%) developed fetal bradycardia after intrauterine blood transfusion; one case (5.26%) died in the uterus. The follow-up visit showed that 17 cases (89.47%) were prematurely born, and 1 case (5.26%) was full term. Conclusions　Fetal anemia caused by maternal-fetal Rh blood group incompatibility can be effectively treated by intrauterine transfusion. In terms of nursing, it is necessary to strengthen the care of fetal intrauterine transfusion, including preoperative psychological care, medication care, and article preparation, intraoperative postural care, medication care, transfusion care, and disease observation, and postoperative complications observation and nursing and health guidance, which is of great significance to ensure the effect of blood transfusion and reduce complications of intrauterine transfusion.

Key words:

Anemia, Rh blood group system, Intrauterine blood transfusion, Fetus, Nursing

摘要：

目的　探讨母胎Rh血型不合胎儿贫血行宫内输血的效果及总结护理经验，以提高疗效及降低宫内输血并发症。方法　采取非随机对照研究，采用便利抽样法，抽取2020年1月至2022年6月在中山大学附属第一医院因母胎Rh血型不合胎儿贫血行宫内输血治疗的19例孕妇为研究对象。孕妇年龄为（31.39±4.13）岁，孕周为（26.34±4.71）周，其中初产妇2例，经产妇17例，不良孕产史9例，伴有胎儿水肿4例。给予宫内输血，并在宫内输血前、中、后给予相应的护理，记录宫内输血前后胎儿血红蛋白（Hb）浓度、红细胞压积（HCT）及输血后并发症发生情况，统计学方法采用t检验。结果　输血后，胎儿Hb浓度及HCT均较输血前升高［（121.56±27.69）g/L比（69.90±22.34）g/L、（36.87±7.84）%比（21.17±6.52）%］，差异均有统计学意义（t=-11.937、-12.702，均P<0.05）；输血后发生1例（5.26%）胎儿心动过缓；1例（5.26%）胎死宫内；随访显示17例（89.47%）早产，1例（5.26%）足月生产。结论　母胎Rh血型不合胎儿贫血行宫内输血取得了较好的效果。护理方面需加强胎儿宫内输血的护理，包括术前做好心理护理、用药护理、物品准备，术中做好体位护理、用药护理、输血护理、病情观察，术后做好并发症观察及护理、健康指导，其对保证输血效果、降低宫内输血并发症有重要意义。

关键词:

贫血, Rh血型系统, 宫内输血, 胎儿, 护理