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目的:探讨急性等容稀释性自体输血在产科大出血手术中的应用效果。方法:选择2013-01-2015-06急性等容稀释性自体输血的58例孕产妇合并大出血休克患者(观察组)。对照组为行异体血输注的同类住院患者62例。用纱布称量法及引流量计算2组术中失血量并记录;对2组患者进行血常规检测,观察并比较围术期血液指标变化情况。记录观察组围术期凝血功能变化情况。结果:1观察组平均输自体血(573.6±162.7)ml,异体血输注量明显少于对照组(P<0.05);2观察组RBC、HB及HCT稍有下降,与术前比较差异无统计学意义(P>0.05);但明显高于对照组术后水平(P<0.05);3观察组血液稀释后FIB与PLT明显下降(P<0.05),术毕回升至术前水平。结论:ANH自体输血能够减少产科大出血患者术中失血,能减少异体血输注,对凝血功能无明显影响,有利于维持血流动力学稳定。
Objective: To investigate the effect of acute isovolumic autologous blood transfusion in obstetric hemorrhage. Methods: Fifty-eight pregnant women with acute isovolumic autotransfusion during 2013-01-2015-06 were enrolled in the study. The control group was 62 cases of similar inpatients with allogeneic blood transfusion. The amount of blood loss in the two groups was calculated and recorded with gauze weighing method and drainage volume. Blood routine examination was performed on the two groups of patients, and the changes of perioperative blood indexes were observed and compared. The observation group changes of coagulation function during perioperative period. Results: 1 In the observation group, mean blood autologous blood was delivered (573.6 ± 162.7) ml, and the amount of allogeneic blood transfusion was significantly less than that of the control group (P <0.05); 2 The RBC, HB and HCT in the observation group decreased slightly (P> 0.05), but significantly higher than that of the control group (P <0.05). 3 The FIB and PLT in the observation group decreased significantly after hemodilution (P <0.05), and returned to the preoperative level at the end of the operation. CONCLUSION: ANH autotransfusion can reduce blood loss during operation in patients with obstetric major hemorrhage, reduce allogeneic blood transfusion, and have no significant effect on blood coagulation function, which is in favor of maintaining hemodynamic stability.