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目的:探讨急性等容血液稀释(ANH)对中央型前置胎盘剖腹产患者异体输血的影响及安全性。方法:将60例中央型前置胎盘剖腹产产妇随机分为观察组与对照组,每组30例。观察组行术前ANH,对照组术前无特殊处理。比较观察组产妇ANH前后血红蛋白(Hb)、红细胞比容(Hct)及碱剩余(BE)、血乳酸(LAC)等血气指标;比较2组产妇术后2hHb、Hct、PLT及异体输血率;记录2组新生儿脐动脉血Hb、Hct、BE、Lac及Apgar评分。结果:(1)与ANH前相比,观察组ANH后Hb、Hct及BE水平有所下降,Lac有所升高,但差异无统计学意义(P>0.05);(2)观察组术后2hHb、Hct、PLT平均水平明显高于对照组(P<0.05),异体输血率明显低于对照组(P<0.05);(3)2组新生儿脐动脉血Hb、Hct、BE、Lac均值及Apgar评分比较,差异无统计学意义(P>0.05)。结论:ANH对中央型前置胎盘剖腹产产妇及胎儿血气指标无不良影响,可有效减少术中红细胞丢失和异体血输注,是一种安全有效的输血方式。
Objective: To investigate the effect and safety of acute isovolemic hemodilution (ANH) on allogeneic blood transfusion in patients with central placenta previa. Methods: Sixty cases of central placenta previa were randomly divided into observation group and control group, with 30 cases in each group. The observation group before operation ANH, the control group without preoperative special treatment. Hb, Hb, BE and LAC were compared between the two groups before and after ANH. The levels of Hb, Hct, PLT and allogeneic blood transfusion were compared between 2 groups after maternal ANH. Hb, Hct, BE, Lac and Apgar scores in 2 groups of newborn umbilical artery blood. Results: (1) The levels of Hb, Hct and BE in the observation group decreased compared with those before ANH, Lac increased, but the difference was not statistically significant (P> 0.05); (2) 2hHb, Hct and PLT were significantly higher than those in the control group (P <0.05), and the rate of allogeneic blood transfusion was significantly lower than that of the control group (P <0.05). (3) The mean Hb, Hct, And Apgar score, the difference was not statistically significant (P> 0.05). CONCLUSION: ANH has no adverse effect on blood gas index of maternal and fetus in caesarean section of central placenta previa, which can effectively reduce intraoperative red blood cell loss and allogeneic blood transfusion. It is a safe and effective blood transfusion method.