论文部分内容阅读
目的:探讨急性等容血液稀释(ANH)对异位妊娠患者围手术期血常规及凝血指标的影响。方法:选择2015-01-2016-08妇产科异位妊娠患者81例,以采用ANH式自体输血的35例患者为ANH组,其余46例患者为对照组。分别于手术前、血液稀释后、自体血回输前和自体血回输后抽取静脉血测定ANH组血红蛋白(Hb)、血细胞比容(Hct)、血小板数(PLT)、纤维蛋白原(Fib)、凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)、D-二聚体(D-D),并与对照组进行比较。结果:(1)ANH组异体血输注量少于对照组(P<0.05);(2)ANH组血液稀释后及自体血回输前Hb、Hct、PLT下降(P<0.05),回输自体血后显著回升。(3)ANH组血液稀释后及自体血回输前Fib下降(P<0.05),回输自体血后回升。ANH组自体血回输后APTT及D-D均低于对照组术后水平(P<0.05)。结论:术前ANH能减少异位妊娠患者术中红细胞的丢失,减少异体血输注,不会造成凝血功能障碍。
Objective: To investigate the effect of acute normovolemic hemodilution (ANH) on the blood and coagulation indexes during perioperative period in patients with ectopic pregnancy. Methods: A total of 81 patients with gynecologic ectopic pregnancy selected from January 2015 to August 2016 were enrolled in this study. 35 patients with ANH autologous blood transfusion were ANH group, and the other 46 patients were control group. Venous blood samples were collected before operation, after hemodilution, before autologous blood transfusion, and after autologous blood transfusion. The levels of hemoglobin (Hb), hematocrit (Hct), platelet count (PLT), fibrinogen , Prothrombin time (PT), partial thromboplastin time (APTT), thrombin time (TT) and D-dimer (DD) were measured and compared with the control group. Results: (1) The amount of allogeneic blood transfusion in ANH group was less than that in control group (P <0.05). (2) The levels of Hb, Hct and PLT were decreased in ANH group after hemodilution and autologous blood transfusion (P <0.05) Significantly increased after autologous blood. (3) Fib levels in ANH group decreased after hemodilution and autologous blood transfusion (P <0.05), and then returned to autologous blood. APTT and D-D in ANH group after autotransfusion were lower than those in control group (P <0.05). Conclusion: Preoperative ANH can reduce the loss of intraoperative erythrocytes in patients with ectopic pregnancy, reduce allogeneic blood transfusion, will not cause coagulation disorders.