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目的:探讨重组人促红细胞生长素(rh-EPO)与蔗糖铁在孕妇妊娠晚期预存式自体输血中的临床应用价值。方法:以2014-01-2015-06术中失血量>400 ml、妊娠晚期行预存式自体输血的112例孕妇为研究对象,按入院顺序分为2组,每组56例。2组患者分别于术前7d和术前3d采血400ml,每次采血后按1∶1的比例输注400ml琥珀酰明胶和复方乳酸钠混合液以补充血容量,术中或术后回输给患者。观察组于术前10d起隔日皮下注射rh-EPO 150U/kg,同时静脉补充蔗糖铁注射液100mg,1次/3d,用至术后第7天;对照组不应用rh-EPO和蔗糖铁注射液。记录2组患者第1次采血前、术前1h、术后第1天、第5天的RBC、Hb、Hct以及围术期并发症、术中失血量和输血量、术后恢复情况。结果:与第1次采血前比较,2组术前1h、术后第1天、第5天RBC、Hb及Hct明显降低(P<0.05)。与对照组比较,观察组术后第1天、第5天RBC、Hb及Hct明显升高(P<0.05);2组患者自体血回输过程中未发生寒战、发热、过敏等输血不良反应。观察组未发生血黏度增高、血栓等并发症。结论:rh-EPO与蔗糖铁联合应用于孕妇妊娠晚期预存式自体输血,可充分发挥患者自身的造血潜能,显著改善患者的贫血状况。
Objective: To investigate the clinical value of recombinant human erythropoietin (rh-EPO) and sucrose iron in preterm stored blood transfusions in pregnant women. Methods: One hundred and twelve pregnant women with preoperative blood transfusions in the third trimester of pregnancy with blood loss> 400 ml during 2014-01-2015-06 were divided into two groups according to admission order, 56 cases in each group. Two groups of patients were preoperatively 7d and preoperative 3d blood 400ml, after each blood collection 1: 1 ratio of infusion of 400ml succinyl gelatin and compound sodium lactate mixture to supplement the blood volume, intraoperative or postoperative infusion back to patients . In the observation group, rh-EPO 150 U / kg was injected subcutaneously every other day from the 10th day before operation, while intravenous infusion of sucrose iron injection 100 mg once daily for 3 days was used until the 7th day after operation. In the control group, rh-EPO and sucrose injection liquid. The RBC, Hb, Hct and the perioperative complications, blood loss, blood transfusion, and postoperative recovery were recorded before the first blood collection, 1h before surgery, 1h after surgery and 5d after the surgery. Results: Compared with those before the first blood collection, RBC, Hb and Hct decreased significantly (P <0.05) on the first day, the first day and the fifth day after operation in both groups. Compared with the control group, RBC, Hb and Hct were significantly increased in the observation group on the first day and the fifth day after operation (P <0.05). No adverse reactions such as chills, fever and allergies were found in the blood transfusion in the two groups . The observation group did not occur increased blood viscosity, thrombosis and other complications. Conclusion: rh-EPO combined with sucrose iron can be used to pre-deposit autologous blood transfusion in pregnant women in the third trimester of pregnancy, which can give full play to the patient’s own hematopoietic potential and significantly improve the patient’s anemia.