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目的:探讨妊娠晚期储存式自体输血在前置胎盘孕妇中的应用价值。方法:选择2011-03-2015-06妇产科住院分娩的前置胎盘患者83例。在择期剖宫产终止妊娠前3周,每次采血200ml储存备用。采血前30min内和采血后2h内行患者血压、心率监测及胎心监护;采血前后监测孕妇血压、心率、呼吸情况;检测采血前后和自体血回输后红细胞(RBC)、血红蛋白(Hb)、红细胞沉降率(Hct)、血小板(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)等指标。结果:采血及回输过程中母胎一般情况良好,新生儿Apgar评分为9~10分。83例前置胎盘孕妇采血前后及分娩后血压、心率、呼吸均无明显变化(P>0.05)。采血前后和自体血回输后RBC、Hb、Hct、PLT、PT、APTT等指标无显著变化(P>0.05)。结论:妊娠晚期前置胎盘孕妇应用储存式自体输血安全性好,不会对母胎产生明显影响,具有一定的临床应用价值。
Objective: To investigate the value of late-stage storage-type autologous blood transfusion in pregnant women with placenta previa. Methods: 83 cases of placenta previa in obstetrics and gynecology hospitalized during 2011-03-2015-06 were selected. Cesarean section in the elective cessation of pregnancy before the first 3 weeks, each 200ml blood reserve for use. Blood pressure, heart rate and fetal heart rate were monitored within 30 min before and 2 h after blood collection. Blood pressure, heart rate and respiration of pregnant women were monitored before and after blood collection. The levels of red blood cells (RBC), hemoglobin (Hb), red blood cells (Hct), platelet (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT) and other indicators. Results: The mother fetus was generally good in the process of blood collection and transfusion, and the neonatal Apgar score was 9-10. There were no significant changes in blood pressure, heart rate and respiration in 83 cases of placenta previa before and after delivery and postpartum delivery (P> 0.05). There was no significant change of RBC, Hb, Hct, PLT, PT, APTT and other indexes before and after blood collection and autologous blood transfusion (P> 0.05). Conclusion: Pregnant women with placenta previa in the third trimester of pregnancy should have good safety of storage autologous blood transfusion and have no significant effect on the mother’s fetus, which has certain clinical value.