自体血回输在宫外孕破裂出血术中的应用

2014-10-17王鹏宇蔡建明黄华君

浙江医学教育 2014年2期

关键词：血浆手术

王鹏宇，蔡建明，黄华君

(诸暨市人民医院，浙江诸暨 311800)

自体血回输在宫外孕破裂出血术中的应用

王鹏宇，蔡建明，黄华君

(诸暨市人民医院，浙江诸暨 311800)

目的：探讨自体血回输在宫外孕破裂出血术中应用的临床意义、安全性和效果。方法将本院2007年3月至2009年6月间诊断为宫外孕破裂出血行手术治疗的395例患者中腹腔出血量大于500mL的92例作对照组，以2010年3月至2012年6月间诊断为宫外孕破裂出血行手术治疗的613例患者中术中出血量大于500mL的126例作为观察组。观察组术中自体血回输。观察记录2组患者术中出血量、自体血回输量、异体血用量，检测术前(T0)、输血结束后1h(T1)血红蛋白浓度(Hb)、凝血功能、血小板。结果与对照组比较，观察组术中异体输血比例及手术患者人均异体输血量明显减少(P<0.05)，术后血红蛋白浓度高于对照组(P<0.05)，2组患者的凝血功能指标有延长(P<0.05)，但血小板计数无明显变化(P>0.05)，所有患者手术过程中均未出现凝血功能障碍情况。结论宫外孕破裂出血术中采用自体血回输能明显减少异体血用量，安全有效。

宫外孕；自体血；回输

Abstract：[Objective]To investigate the clinical significance, safety and effect of autologous blood transfusion for rupture hemorrhage in ectopic pregnancy. [Method] 395 ruptured ectopic pregnancy patients from March 2007 to Jne 2009 were enrolled to our hospital to be operated. Among these patients, 92 cases with abdominal bleeding volume over 500ml were selected as control group. 613 ruptured ectopic pregnancy patients from March 2010 to June 2012 were enrolled to our hospital to be operated. Among these patients, 126 cases with abdominal bleeding volume over 500ml were selected as observation group. The observation group was treated with autologous blood transfusion. The amount of bleeding, autologous blood transfusion and allogeneic blood were observed and recorded. The concentration of hemoglobin (Hb)、coagulation function, platelet were detected before operation(T0) and after blood transfusion 1h(T1). [Results] Compared with the control group, the proportion of patients with allogeneic blood transfusion and operation average homologous blood transfusion in operation significantly reduced in observation group(P<0.05). Their hemoglobin concentration were higher than that of the control group after operation(P<0.05). Blood coagulation indexes of two groups prolonged(P<0.05), but there was no significant changes in platelet count(P>0.05). Coagulation dysfunction were not found in the operation process. [Conclusion] The autologous blood transfusion for ruptured ectopic pregnancy operation can reduce homologous blood volume and is safe and effective.

Keywords：ectopic pregnancy;autologous blood;transfusion

宫外孕破裂出血患者在急诊手术的同时急需输血治疗。近年来，术中自体血回输技术逐渐应用。如何安全、有效地进行自体血回输，是麻醉科医生需要关注的一个实际问题。本文对诊断为宫外孕破裂出血且术中接受自体血回输的安全性和效果进行分析，探讨其在宫外孕手术中的应用价值。