| 摘要: |
| ［摘要］ 目的 探讨血液回收联合低温保护技术应用于基层医院大出血孕产妇就地急救手术中的临床效果。方法 选择2017-01～2019-12桂平市人民医院急诊收治的大出血孕产妇患者40例，其中20例在基层医院实施急救手术（研究组），另20例在该院（市级医院）实施急救手术（对照组）。比较两组回收洗涤血红细胞（RBC）的质量、功能、形态，以及两组的输注异体血情况和术后结局。结果 两组术中出血量及洗涤RBC量比较差异无统计学意义（P>0.05）。两组回收洗涤RBC的RBC计数、血红蛋白（Hb）、血细胞比容(Hct)、P50（Hb氧饱和度为50%时的氧分压）、K+、Ca2+比较差异无统计学意义（P>0.05）。两组回收洗涤RBC的细菌培养结果均为阴性。镜下观察见两组回收洗涤RBC的大小形态均一，呈双凹圆盘状，无破裂，无游离血红蛋白(FHB)，无胎儿鳞状上皮细胞、毳毛、角化上皮、胎脂等有形物质。研究组术中接受异体输血11例，对照组术中接受异体输血3例，差异有统计学意义（P<0.05）。研究组的异体输血量大于对照组，输血费用高于对照组，差异有统计学意义（P<0.05）。两组抢救成功率、术后发热发生率及患者满意率比较差异无统计学意义（P>0.05）。结论 联合血液回收和低温保护技术可在基层医院妇产科急症术中有效回收利用患者自体血液，方法安全有效，节约血源。 |
| 关键词: 血液回收 低温保护 基层医院 孕产妇 大出血 临床效果 |
| DOI：10.3969/j.issn.1674-3806.2021.02.12 |
| 分类号:R 719 |
| 基金项目:贵港市科学研究与技术开发计划项目（编号：贵科转1701010） |
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| A study on the clinical effect of blood recovery combined with low temperature protection technique in emergency operation for pregnant and lying-in women with massive hemorrhage in primary hospitals |
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XU Yin-li, JIANG Li-ping, HUANG Chao-ying, et al.
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Department of Anesthesiology, Guiping People′s Hospital, Guangxi 537200, China
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| Abstract: |
| ［Abstract］ Objective To explore the clinical effect of blood recovery combined with low temperature protection technique in emergency operation for pregnant and lying-in women with massive hemorrhage in primary hospitals. Methods Forty pregnant and lying-in women with massive hemorrhage who were admitted to Guiping People′s Hospital for emergency treatment were selected from January 2017 to December 2019. Among them, 20 cases were performed emergency surgery in primary hospitals(the research group), and the other 20 cases were performed emergency surgery in Guiping People′s Hospital(a city-level hospital)(the control group). The quality, function and morphology of recovered and washed red blood cell(RBC) were compared between the two groups, as well as the transfusion of allogeneic blood and the postoperative outcomes. Results There were no significant differences in the amount of intraoperative blood loss and the amount of washed RBC between the two groups(P>0.05). There were no significant differences in the RBC count, hemoglobin(Hb), hematocrit(Hct), P50(oxygen partial pressure when Hb oxygen saturation was 50%), K+ and Ca2+ of the recovered and washed RBC between the two groups(P>0.05). The bacterial culture results of the recovered and washed RBC were negative in both groups. Microscopically, the recovered and washed RBCs were uniform in size and shape, with a double concave disc shape, no rupture, no free hemoglobin(FHB), no fetal squamous cells, no vellus hair, no keratinized epithelium, no fetal fat and no other tangible substances in both groups. Eleven patients in the research group received allogeneic blood transfusion, while 3 patients in the control group received allogeneic blood transfusion, and the difference was statistically significant(P<0.05). The amount of allogeneic blood transfusion in the research group was greater than that in the control group, and the blood expenses in the research group were higher than those in the control group, and the differences were statistically significant between the two groups(P<0.05). There were no significant differences in the rescue success rate, postoperative fever incidence rate and patients′ satisfaction rate between the two groups(P>0.05). Conclusion The combined blood recovery and low temperature protection technique can effectively recover the patients′ autologous blood during emergency operations in the department of obstetrics and gynecology of primary hospitals. The method is safe and effective and saves blood sources. |
| Key words: Blood recovery Low temperature protection Primary hospital Pregnant and lying-in women Massive hemorrhage Clinical effect |
