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目的:探讨异位妊娠术中洗涤式自体输血的应用价值。方法:以2011-03-2015-06采用自体血液回收机进行自体血回输的33例异位妊娠急诊手术患者为自体输血组,以同期行异体血输注的同类患者45例为异体输血组。记录2组患者术中出血量、回收血量、异体血输注量、不良反应及输血费用等;观察自体输血组围术期心率(HR)、收缩压(SBP)、舒张压(DBP)和平均动脉压(MAP)、中心静脉压(CVP)等生命体征指标的变化情况;以及白细胞(WBC)、血红蛋白(Hb)、血细胞比容(HCT)及纤维蛋白原(FIB)、血小板(PLT)、凝血酶原时间(PT)、部分凝血活酶时间(APTT)及血氧饱和度(SpO2)等指标变化情况;对2组患者进行术后随访和预后比较。结果:1自体输血组在异体血输注量、输血反应发生率和输血费用显著低于异体输血组(P<0.05);2自体输血组回输后及术后24hSBP、MAP及CVP明显升高(P<0.05),HR明显下降(P<0.05),WBC、Hb、HCT、PLT、SpO2明显升高(P<0.05);3自体输血组伤口拆线时间(5.0±1.9)d,住院时间(5.7±2.1)d,明显少于异体输血组的拆线时间(6.6±2.2)d和住院时间(7.4±3.1)d,差异有统计学意义(P<0.05)。结论:采用血液回收机对异位妊娠急诊手术患者进行自体血回输,不但可快速回收回输自体血,还可显著减少输血反应和输血费用,缩短住院时间,具有重要的血液保护和临床应用价值。
Objective: To investigate the value of washing autologous blood transfusion during ectopic pregnancy. Methods: Totally 33 ectopic pregnancy emergency transfusions were performed on autologous blood transfusion with autologous blood collection machines from 2011-03-2015-06. Among them, 45 cases of allogeneic transfusion group . The intraoperative blood loss, blood volume recovery, allogeneic blood transfusion, adverse reactions and blood transfusion costs were recorded in 2 groups. HR, SBP, DBP, MAP, CVP and other vital signs; and WBC, Hb, HCT, fibrinogen (FIB), platelet (PLT) , Prothrombin time (PT), partial thromboplastin time (APTT) and oxygen saturation (SpO2) and other indicators of changes; two groups of patients were followed up and compared prognosis. Results: 1 The autologous blood transfusion group had significantly lower blood transfusion rate and blood transfusion costs than allogeneic blood transfusion group (P <0.05); 2 The autoantiblood transfusion group had significantly higher 24hSBP, MAP and CVP after transfusion and after operation Hb, HCT, PLT and SpO2 were significantly increased (P <0.05); HR was significantly decreased (P <0.05); WBC, Hb, HCT, (5.7 ± 2.1) d, which was significantly lower than that of allogeneic blood transfusion group (6.6 ± 2.2) d and hospital stay (7.4 ± 3.1) d, with statistical significance (P <0.05). Conclusion: Blood transfusion machine for autologous blood transfusion in patients with ectopic pregnancy emergency surgery can not only quickly recover autologous blood transfusion, but also significantly reduce the transfusion reaction and blood transfusion costs, shorten the hospital stay, has important blood protection and clinical application value.