产科自体血回输对母体凝血功能、血流动力学及肝肾功能的影响

摘要

目的 探讨产科自体血回输对母体凝血功能、血流动力学和肝肾功能的影响.方法 选取2015年4月～2016年5月宁波大学附属医院及宁波市鄞州区第二医院产科大出血患者150例,采用随机数字表法分为对照组(75例)与试验组(75例),分别应用异体输血和自体血回输.比较两组患者输血前后凝血功能[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)]、电解质[血钾、血钠、血氯和酸碱度(pH)]、血流动力学[平均动脉压(MAP)、心率(HR)]以及肝肾功能[天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、尿肌酐(Cr)、血尿素氮(BUN)]的变化情况.结果 与输血前比较,两组患者输血后PT、APTT水平、血钾、血钠、血氯、pH值、MAP和HR均明显改变,差异有统计学意义(P＜0.05);而两组输血前后AST、ALT、Cr、BUN水平无明显变化,差异无统计学意义(P＞0.05);输血后与试验组比较,对照组患者APTT、PT、血氯、pH值、MAP和HR变化更明显,差异有统计学意义(P＜0.05).结论 自体血回输应用于产科大出血患者安全有效,值得在临床中广泛应用.%Objective To investigate the effect of blood transfusion on maternal coagulation function,hemodynamics and liver and kidney function in Department of Obstetrics.Methods A total of 150 patients with major obstetric hemorrhage from April 2015 to May 2016 in the Affiliated Hospital of Ningbo University and the Second Hospital of Yinzhou District of Ningbo City were selected and divided into control group (75 cases) and experimental group (75 cases) by a random number table method.Allogeneic blood transfusions and autologous blood transfusions were applied respectively.The differences of coagulation function (APTT,PT),electrolytes (K,Na,Cl and pH),hemodynamics [mean arterial pressure (MAP),heart rate (HR)] and liver and kidney function [aspartate aminotransferase (AST),alanine aminotransferase (ALT),urine creatinine (Cr),blood urea nitrogen (BUN)] were analyzed between the two groups before and after transfusion.Results Compared with pretransfusion,the levels of PT,APTT,serum potassium,sodium,chloride,pH,MAP,and HR were significantly changed in the two groups after transfusion,and the differences were statistically sig nificant (P ＜ 0.05).There was no significant change in the levels of AST,ALT,Cr and BUN before and after the study (P ＞ 0.05).Compared with the experimental group,the levels of PT,APTT,serum chloride,pH,MAP and HR in the control group were changed more obviously,and the differences were statistically significant (P ＜ 0.05).Conclusion Autologous blood transfusion is more safer and effective in patients with obstetric hemorrhage,and it is worthy of being widely used in clinical practice.