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目的探讨急性等容血液稀释(ANH)对异位妊娠手术患者T淋巴细胞亚群及NK细胞的影响。方法将96例异位妊娠手术患者分为血液稀释组(n=50)和库血输注组(n=46)。血液稀释组在术前进行ANH,库血输注组术前不进行ANH,按照输血指南适当输入库存血。测定术前、术后第3天、术后第10天T细胞亚群与NK细胞含量。记录血液稀释组血液采集和回输过程中不良反应发生情况,以及两组临床康复情况。结果血液稀释组术后第3天、术后第10天CD3~+、CD4~+、CD8~+及NK细胞含量与术前比较无显著变化(P>0.05)。库血输注组术后第3天、第10天与术前比较,CD3~+、CD4~+、NK细胞含量明显下降(P<0.05),CD8~+明显上升(P<0.05);血液稀释组术后第3天、第10天CD3~+、CD4~+、CD8~+、NK细胞含量与库血输注组比较,差异有统计学意义(P<0.05)。血液稀释组自体血采集及回输过程中均未发生严重不良反应,术后肠道排气时间、切口拆线时间及住院时间均明显短于库血输注组(P<0.05)。结论 ANH对异位妊娠手术患者T淋巴细胞亚群及NK细胞的影响较小,有助于患者术后康复。
Objective To investigate the effect of acute normovolemic hemodilution (ANH) on T lymphocyte subsets and NK cells in patients undergoing ectopic pregnancy. Methods 96 cases of ectopic pregnancy were divided into hemodilution group (n = 50) and blood bank infusion group (n = 46). ANH was preoperatively performed in the hemodilution group, ANH was not performed prior to preoperative blood transfusion in the blood transfusion group, and stocked blood was appropriately entered in accordance with the transfusion guidelines. The levels of T lymphocyte subsets and NK cells on preoperative day, postoperative day 3, and postoperative day 10 were measured. Record the incidence of adverse reactions during blood collection and reinfusion in hemodilution group, and the clinical rehabilitation of the two groups. Results There was no significant difference in the levels of CD3 ~ +, CD4 ~ +, CD8 ~ + and NK cells on the 3rd day after operation in the hemodilution group and on the 10th day after operation (P> 0.05). The levels of CD3 +, CD4 +, NK cells were significantly decreased (P <0.05) and CD8 + increased significantly (P <0.05) on the 3rd day and the 10th day after operation in the blood transfusion group. The levels of CD3 ~ +, CD4 ~ +, CD8 ~ + and NK cells on the 3rd day and the 10th day after the operation in the dilution group were significantly different from those in the control group (P <0.05). There was no serious adverse reaction in blood thinning group during autologous blood collection and transfusion. The postoperative intestinal excretion time, incision suture removal time and hospitalization time were significantly shorter than those in blood-reservoir infusion group (P <0.05). Conclusion ANH has less effect on T lymphocyte subsets and NK cells in patients undergoing ectopic pregnancy, which is helpful for postoperative recovery.