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目的:探讨急性等容血液稀释对异位妊娠手术患者血常规及细胞因子的影响。方法:选择117例异位妊娠患者,根据自愿原则及是否符合纳入标准分为观察组54例与对照组63例,观察组行术中急性等容血液稀释,对照组行异体输血。测定2组术前、术后RBC、Hb、Hct、PLT等血常规指标及血浆白细胞介素-6(IL-6)、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)水平。结果 :(1)2组在年龄、体重、术前Hb及Hct、失血量等基线资料方面无明显差异(P>0.05),观察组异血输注量明显少于对照组(P<0.05);(2)观察组术后2dRBC、Hb、Hct水平显著高于对照组(P<0.05);(3)与术前比较,2组术后1d、术后7dIL-6均显著升高(P<0.05),观察组升高幅度高于对照组(P<0.05);观察组术后7dIFN-γ显著升高(P<0.05),而对照组术后1d显著下降(P<0.05);2组手术前后TNF-α水平无显著变化(P>0.05)。结论:急性等容血液稀释用于异位妊娠手术,可有效提高红细胞利用率,明显减少患者的异体输血量,减轻输血对患者的免疫抑制作用,具有重要的临床应用价值。
Objective: To investigate the effect of acute normovolemic hemodilution on blood and cytokines in patients undergoing ectopic pregnancy. Methods: A total of 117 patients with ectopic pregnancy were selected and divided into observation group (n = 54) and control group (n = 63) according to voluntary principle and inclusion criteria. Acute normovolemic hemodilution was performed in observation group and allogeneic blood transfusion in control group. The blood routine indexes such as RBC, Hb, Hct, PLT and the levels of plasma interleukin-6, interferon-gamma and tumor necrosis factor- α) level. Results: (1) There was no significant difference in baseline, body mass, preoperative Hb, Hct, blood loss and other baseline data between the two groups (P> 0.05) ; (2) The levels of RBC, Hb and Hct in the observation group were significantly higher than those in the control group on the 2nd postoperative day (P <0.05); (3) Compared with preoperative, the levels of IL- (P <0.05). The increase of observation group was higher than that of the control group (P <0.05). The level of IFN-γ of the observation group was significantly increased on the 7th day after operation (P <0.05) There was no significant change in TNF-α level before and after operation (P> 0.05). Conclusion: Acute normovolemic hemodilution can be used for ectopic pregnancy surgery, which can effectively improve the utilization of erythrocytes, significantly reduce the amount of allogeneic blood transfusion, and reduce the immunosuppressive effects of transfusion on patients. It is of great clinical value.