【摘要】 目的 探讨术中回收式自体输血和异体输血对剖宫产手术产妇肝功能指标和血浆蛋白的影响。方法 回顾性分析2017年2月～2018年10月某三甲医院产科剖宫产手术产妇病例资料,共100例,分为自体输血组(术中回收式自体输血,n=50)和异体输血组(同种异体输血,n=50)。对两组产妇的一般临床资料、手术前后肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)]及血浆蛋白[总蛋白(TP)、白蛋白(Alb)、球蛋白(Glo)]进行统计学分析,并将术中自体血回输量与术中失血量、术后肝功能指标、血浆蛋白进行相关性分析及线性回归分析。结果两组间临床一般资料比较差异无统计学意义(P均>0.05),自体输血组比异体输血组的异体血用量明显减少(P<0.05);两组间平均住院时间及1分钟新生儿评分均无明显差异;同术前相比,两组术后ALP、TP、Alb、Glo均有明显变化(P<0.05),而ALT、AST变化不明显(P>0.05);两组间术后各指标比较差异均无统计学意义(P>0.05);自体输血组术后ALP、TP、Glo与术中自体血回输量呈明显负相关(P<0.05)。结论 术中回收式自体输血是一种安全有效的节约异体血液资源方式,不会引起剖宫产产妇肝功能损害及同种免疫反应,值得在临床推广。更多还原

【Abstract】 Objective To investigate the effects of intraoperative blood salvage and allogeneic blood transfusion on liver function and plasma protein indexes in patients undergoing cesarean delivery.Methods A total of 100 patients undergoing cesarean delivery from February,2017 to October,2018 were enrolled in the retrospective study.The patients were divided into autologous transfusion group (interoperative blood salvage,n=50) and allogeneic transfusion group.(allogeneic blood transfusion,n=50).General clinical data,liver function indicators [alanine aminotransferase (ALT),aspartate aminotransferase (AST),alkaline phosphatase (ALP)] and plasma protein [total protein (TP),Albumin (Alb),globulin (Glo)] before and after surgery in the two-group patients were compared.Correlation and linear regression analysis were used to test correlation of the intraoperative autologous blood transfusion volume with intraoperative blood loss,postoperative liver function index,plasma protein index Results There was no significant difference in clinical general data between the two groups (P>0.05).The amount of allogeneic blood was significantly lower in the autologous transfusion group than that in the allogeneic transfusion group (P<0.05).There was no significant difference between the average hospital stay and the 1 min neonatal score in the two groups.Compared with the preoperative,the ALP,TP,Alb and Glo of the two groups were significantly different(P<0.05),but ALT,AST changes were not obvious(P>0.05);there was no significant difference in postoperative indexes between the two groups (P>0.05);there was a significantly negatively correlation between ALP,TP,Glo and intraoperative autologous blood transfusion volume e (P<0.05) Conclusion Intraoperative blood salvage is a safe and effective way to save allogeneic blood.It is worthy of clinical promotion since Intraoperative blood salvage does not cause liver function damage and allogeneic immune response in patients with cesarean delivery.更多还原