Anesth Analg:中国妇产医院剖宫产分娩过程中靶向细胞回收输血与输注同种异体红细胞之间的相关性研究

2018-04-21 佘玉琦 “罂粟花”微信号

术中自体输血可以减少剖宫产术后异体红细胞输血。本研究评估了在出血风险增加的妇女剖宫产术中有针对性的术中靶向细胞回收输血的实施。

背景与目的:术中自体输血可以减少剖宫产术后异体红细胞输血。本研究评估了在出血风险增加的妇女剖宫产术中有针对性的术中靶向细胞回收输血的实施。

方法:所有接受剖宫产术且妊娠>28周的妇女均纳入本研究。术前细胞收集期(2010-10-1至2012-8-31,共11322例)与实施后的时期(2012-9-1至2015-6-30,共17,456例)使用中断时间序列分析。在实施后的时期,需要输血的妇女在术中进行细胞收集。主要结果是同种异体红细胞的月使用率和急性输血反应的临床表现的发生率。

结果:经过57个月的研究,存在术中靶向细胞回收输血者的每月异体血细胞输注率均数(标准差)为2.2%±0.7%;不存在术中靶向细胞回收输血者,每月异体血细胞输注率均数(标准差)为2.7%±0.9%(95%CI,-1.4%-0.3%,P=0.22)。未实施术中靶向细胞回收输血者,输注同种异体细胞平均为4.1±0.4单位,实施术中靶向细胞回收输血者为3.9±0.9单位(差异为0.2,95%CI,-1.7-1.1单位,P=0.69)。757例(47%)存在术中细胞回收,847例(53%)不存在术中细胞回收,术中细胞回收的术中异体红细胞月使用率较低(差异为0.7%,95%CI,-0.1%-1.4%,P = 0.03),但术后同种异体红细胞的月使用率无变化(差异-0.2%,95%CI,-0.4%-0.7%,P=.56)。急性输血反应的临床表现发生率组间无变化(差异2%,99%CI,-9%-5%,P =.55)。

结论:我们的研究结果表明,在妇女接受剖宫产手术中,有针对性的靶向细胞回收输血可减少术中同种异体红细胞月使用率,但不减少术后同种异体红细胞的月使用率。术中靶向细胞回收输血在剖宫产术中的应用与住院期间较少的同种异体红细胞使用无关。术中靶向细胞回收输血相关的不良事件较少,支持剖宫产术中靶向细胞回收输血的安全性。

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    2018-10-01 经常头晕
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time=2018-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281998, encodeId=381b128199879, content=<a href='/topic/show?id=3dece71531e' target=_blank style='color:#2F92EE;'>#红细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77153, encryptionId=3dece71531e, topicName=红细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Mon Apr 23 01:02:00 CST 2018, time=2018-04-23, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1687972, encodeId=2227168e972b6, content=<a href='/topic/show?id=b3e73898423' target=_blank style='color:#2F92EE;'>#同种异体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38984, encryptionId=b3e73898423, topicName=同种异体)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=23b928427427, createdName=12498768m22(暂无昵称), createdTime=Fri Aug 03 06:02:00 CST 2018, time=2018-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2051123, encodeId=efee205112328, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, 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time=2018-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281998, encodeId=381b128199879, content=<a href='/topic/show?id=3dece71531e' target=_blank style='color:#2F92EE;'>#红细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77153, encryptionId=3dece71531e, topicName=红细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Mon Apr 23 01:02:00 CST 2018, time=2018-04-23, status=1, ipAttribution=)]
    2019-03-21 AspirantSuo
  6. 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  7. 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time=2018-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281998, encodeId=381b128199879, content=<a href='/topic/show?id=3dece71531e' target=_blank style='color:#2F92EE;'>#红细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77153, encryptionId=3dece71531e, topicName=红细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Mon Apr 23 01:02:00 CST 2018, time=2018-04-23, status=1, ipAttribution=)]
    2018-04-26 121832a9m88暂无昵称

    学习了

    0

  8. 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time=2018-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281998, encodeId=381b128199879, content=<a href='/topic/show?id=3dece71531e' target=_blank style='color:#2F92EE;'>#红细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77153, encryptionId=3dece71531e, topicName=红细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Mon Apr 23 01:02:00 CST 2018, time=2018-04-23, status=1, ipAttribution=)]
    2018-04-23 windight
  9. 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time=2018-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281998, encodeId=381b128199879, content=<a href='/topic/show?id=3dece71531e' target=_blank style='color:#2F92EE;'>#红细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77153, encryptionId=3dece71531e, topicName=红细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Mon Apr 23 01:02:00 CST 2018, time=2018-04-23, status=1, ipAttribution=)]
    2018-04-23 zhouqu_8
  10. 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