ANH联合自体血回输与输注异体血治疗异位妊娠的研究
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摘要
目的探讨ANH联合自体血回输与输注异体血治疗异位妊娠的研究。方法方便收集该院2015年3月—2018年1月异位妊娠接受输血的患者,根据患者输血类型,分为研究组(接受ANH联合自体血回输)与对照组(接受输注异体血)。对比两组患者异位妊娠手术中失血量、库存血输注量及术中回收血;两组患者CRP、ESR及WBC在不同手术时间点水平;两组患者免疫指标IgM和IgG在不同手术时间点水平;两组手术治疗不同时间人绒毛膜促性腺激素水平;两组手术后康复情况。结果研究组和对照组患者异位妊娠手术中失血量分别为(1 263.47±402.38)mL、(1 205.75±412.28)mL,差异无统计学意义(t=0.524,P>0.05);研究组和对照组库存血输注量及术中回收血分别为(512.38±16.28)mL、(502.33±94.21)m L、(1 134.35±356.82)mL,差异有统计学意义(t=9.363、15.242,P<0.05),研究组明显少于对照组;研究组和对照组手术前CRP、ESR及WBC分别为(4.05±0.39)mg/L、(7.12±1.02)mm/L、(5.93±1.54)×109/L、(4.11±0.42)mg/L、(7.08±1.13)mm/L、(6.02±1.66)×109/L,差异无统计学意义(t=0.269、0.285、0.112,P>0.05);研究组和对照组手术后24hCRP、ESR及WBC分别为(28.36±2.47)mg/L、(25.34±4.13)mm/L、(9.05±1.73)×109/L、(39.63±3.68)mg/L、(34.66±5.05)mm/L、(12.54±1.94)×109/L,研究组低于对照组,差异有统计学意义(t=6.285、6.845、7.269,P<0.05);研究组和对照组手术前IgG及IgM分别为(12.68±2.31)g/L、(1.31±0.25)g/L、(12.67±2.28)g/L、(1.32±0.26)g/L,差异无统计学意义(t=0.169、0.247,P>0.05);研究组和对照组手术后24 h IgG及IgM分别为(11.34±2.05)g/L、(1.14±0.24)g/L、(8.16±1.13)g/L、(1.01±0.22)g/L,研究组高于对照组,差异有统计学意义(t=6.584,7.159,P<0.05);研究组和对照组手术后康复情况(肠道排气时间、切口拆线时间、住院时间)分别为(1.37±0.55)d、(5.13±1.56)d、(5.44±2.13)d、(1.98±0.67)d、(6.29±1.75)d、(7.36±2.28)d,研究组明显优于对照组,差异有统计学意义(t=7.425、6.825、5.824,P<0.05)。结论相对于输注异体血治疗异位妊娠,ANH联合自体血回输在补充血容量、提高机体免疫功能及促进患者术后康复情况上明显具有优势。
Objective To investigate the effect of ANH combined with autologous blood transfusion and allogeneic blood transfusion on ectopic pregnancy. Methods The patients with ectopic pregnancy received blood transfusion in our hospital from March 2015 to January 2018 were convenient divided into study group(receiving ANH combined with autologous blood transfusion) and control group(receiving allogeneic blood transfusion) according to the type of blood transfusion. The blood loss, stored blood transfusion and intraoperative blood recovery during ectopic pregnancy operation, the levels of CRP,ESR and WBC at different operation time points, the levels of IgM and IgG at different operation time points, the levels of human chorionic gonadotropin at different operation time, and the recovery after operation in the two groups were compared between the two groups. Results There was no significant difference in blood loss between the study group and the control group in ectopic pregnancy surgery(1 263.47±402.38)mL,(1 205.75±412.28)mL,(t=0.524, P>0.05). The blood transfusion volume of the study group and the control group were(512.38±16.28)mL,(502.33±94.21)mL,(1 134.35±356.82)mL respectively(t=9.363, 15.242, P<0.05), and the difference was significant(P<0.05). CRP, ESR and WBC before operation were(4.05±0.39)mg/L,(7.12±1.02)mm/L,(5.93±1.54)×109/L,(4.11±0.42)mg/L,(7.08±1.13)mm/L,(6.02±1.66)×109/L, and there was no significant difference(t=0.269, 0.285, 0.112, P>0.05). CRP, ESR, ESR and WBC 24 hours after surgery in study group and control group were(28.36±2.47)mg/L,(25.34±4.13)mm/L,(9.05±1.73)×109/L,(39.63±3.68)mg/L,(34.66±5.05)mm/L,(12.54±1.94)×109/L, and there were significant difference(t=6.285, 6.845, 7.269, P<0.05). The results of this study are as follows: 1.The levels of IgG and IgM in the study group and the control group before operation were(12.68±2.31)g/L,(1.31±0.25)g/L,(12.67±2.28)g/L,(1.32±0.26)g/L, respectively, with no significant difference(t=0.169, 0.247,P>0.05). The levels of IgG and IgM at 24 hours after operation in the study group and the control group were(11.34±2.05)g/L,(1.14±0.24)g/L,(8.16±1.13)g/L,(1.01±0.22)g/L, respectively(t=6.584, 7.159, P<0.05). Intestinal exhaust time, incision thread removal time, hospitalization time of the study group and the control group were(1.37±0.55)d,(5.13±1.56)d,(5.44±2.13)d(1.98±0.67)d,(6.29±1.75)d,(7.36±2.28)d, respectively. The study group was significantly better than the control group(t=7.425, 6.825, 5.824, P<0.05).Conclusion Compared with the treatment of ectopic pregnancy with allogeneic blood transfusion, ANH combined with autologous blood transfusion has obvious advantages in supplementing blood volume, improving immune function and promoting the recovery of patients after operation.
Objective To investigate the effect of ANH combined with autologous blood transfusion and allogeneic blood transfusion on ectopic pregnancy. Methods The patients with ectopic pregnancy received blood transfusion in our hospital from March 2015 to January 2018 were convenient divided into study group(receiving ANH combined with autologous blood transfusion) and control group(receiving allogeneic blood transfusion) according to the type of blood transfusion. The blood loss, stored blood transfusion and intraoperative blood recovery during ectopic pregnancy operation, the levels of CRP,ESR and WBC at different operation time points, the levels of IgM and IgG at different operation time points, the levels of human chorionic gonadotropin at different operation time, and the recovery after operation in the two groups were compared between the two groups. Results There was no significant difference in blood loss between the study group and the control group in ectopic pregnancy surgery(1 263.47±402.38)mL,(1 205.75±412.28)mL,(t=0.524, P>0.05). The blood transfusion volume of the study group and the control group were(512.38±16.28)mL,(502.33±94.21)mL,(1 134.35±356.82)mL respectively(t=9.363, 15.242, P<0.05), and the difference was significant(P<0.05). CRP, ESR and WBC before operation were(4.05±0.39)mg/L,(7.12±1.02)mm/L,(5.93±1.54)×109/L,(4.11±0.42)mg/L,(7.08±1.13)mm/L,(6.02±1.66)×109/L, and there was no significant difference(t=0.269, 0.285, 0.112, P>0.05). CRP, ESR, ESR and WBC 24 hours after surgery in study group and control group were(28.36±2.47)mg/L,(25.34±4.13)mm/L,(9.05±1.73)×109/L,(39.63±3.68)mg/L,(34.66±5.05)mm/L,(12.54±1.94)×109/L, and there were significant difference(t=6.285, 6.845, 7.269, P<0.05). The results of this study are as follows: 1.The levels of IgG and IgM in the study group and the control group before operation were(12.68±2.31)g/L,(1.31±0.25)g/L,(12.67±2.28)g/L,(1.32±0.26)g/L, respectively, with no significant difference(t=0.169, 0.247,P>0.05). The levels of IgG and IgM at 24 hours after operation in the study group and the control group were(11.34±2.05)g/L,(1.14±0.24)g/L,(8.16±1.13)g/L,(1.01±0.22)g/L, respectively(t=6.584, 7.159, P<0.05). Intestinal exhaust time, incision thread removal time, hospitalization time of the study group and the control group were(1.37±0.55)d,(5.13±1.56)d,(5.44±2.13)d(1.98±0.67)d,(6.29±1.75)d,(7.36±2.28)d, respectively. The study group was significantly better than the control group(t=7.425, 6.825, 5.824, P<0.05).Conclusion Compared with the treatment of ectopic pregnancy with allogeneic blood transfusion, ANH combined with autologous blood transfusion has obvious advantages in supplementing blood volume, improving immune function and promoting the recovery of patients after operation.
引文
[1]汪福珍,李红梅,赵芳,等.ANH与AHH在异位妊娠手术中的应用效果比较[J].临床输血与检验,2018,20(2):120-123.
[2]佟薇,王美娜,汪福珍,等.急性等容血液稀释对异位妊娠患者围手术期血常规及凝血指标的影响[J].临床血液学杂志:输血与检验,2017,30(6):926-929.
[3]王美娜,佟薇,汪福珍,等.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[J].临床血液学杂志:输血与检验,2017,30(5):771-773.
[4]赵芳,汪福珍,李红梅,等.ANH联合控制性降压减少异位妊娠手术异体输血的临床研究[J].临床血液学杂志:输血与检验,2017,30(5):759-761.
[5]李红梅,汪福珍,赵芳,等.国产羟乙基淀粉急性等容血液稀释对异位妊娠手术患者肾功能的影响[J].临床血液学杂志:输血与检验,2017,30(5):765-767.
[6]汪福珍,李红梅.急性等容血液稀释联合回收式自体输血在异位妊娠手术患者中的应用研究[J].国际检验医学杂志,2017,38(11):1507-1509.
[7]汪福珍,赵芳,李红梅.胶体液应用于ANH对异位妊娠手术患者血流动力学的影响[J].临床血液学杂志:输血与检验,2017,30(3):443-446.
[8]赵芳,汪福珍,李红梅.ANH对异位妊娠手术患者炎症反应和异体输血的影响[J].临床血液学杂志:输血与检验,2017,30(1):102-105.
[9]李红梅,汪福珍,赵芳,等.ANH对异位妊娠手术患者T淋巴细胞亚群及NK细胞的影响[J].热带医学杂志,2017,17(1):81-84.
[10]孙楠,温转,程建欣.急性等容血液稀释联合自体血回输对异位妊娠手术患者免疫功能及预后的影响[J].中国输血杂志,2016,29(10):1150-1153.
[11]关开华,邓群波,戴静华,等.术前急性血液稀释减少异位妊娠手术异体输血的临床研究[J].实用妇产科杂志,2007(11):682-684.
[12]裴丽鹏,陈红.急性等容稀释在腹腔镜妇科恶性肿瘤根治手术中的应用.中国肿瘤临床与康复,2015,22(12):1456-1458.
[2]佟薇,王美娜,汪福珍,等.急性等容血液稀释对异位妊娠患者围手术期血常规及凝血指标的影响[J].临床血液学杂志:输血与检验,2017,30(6):926-929.
[3]王美娜,佟薇,汪福珍,等.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[J].临床血液学杂志:输血与检验,2017,30(5):771-773.
[4]赵芳,汪福珍,李红梅,等.ANH联合控制性降压减少异位妊娠手术异体输血的临床研究[J].临床血液学杂志:输血与检验,2017,30(5):759-761.
[5]李红梅,汪福珍,赵芳,等.国产羟乙基淀粉急性等容血液稀释对异位妊娠手术患者肾功能的影响[J].临床血液学杂志:输血与检验,2017,30(5):765-767.
[6]汪福珍,李红梅.急性等容血液稀释联合回收式自体输血在异位妊娠手术患者中的应用研究[J].国际检验医学杂志,2017,38(11):1507-1509.
[7]汪福珍,赵芳,李红梅.胶体液应用于ANH对异位妊娠手术患者血流动力学的影响[J].临床血液学杂志:输血与检验,2017,30(3):443-446.
[8]赵芳,汪福珍,李红梅.ANH对异位妊娠手术患者炎症反应和异体输血的影响[J].临床血液学杂志:输血与检验,2017,30(1):102-105.
[9]李红梅,汪福珍,赵芳,等.ANH对异位妊娠手术患者T淋巴细胞亚群及NK细胞的影响[J].热带医学杂志,2017,17(1):81-84.
[10]孙楠,温转,程建欣.急性等容血液稀释联合自体血回输对异位妊娠手术患者免疫功能及预后的影响[J].中国输血杂志,2016,29(10):1150-1153.
[11]关开华,邓群波,戴静华,等.术前急性血液稀释减少异位妊娠手术异体输血的临床研究[J].实用妇产科杂志,2007(11):682-684.
[12]裴丽鹏,陈红.急性等容稀释在腹腔镜妇科恶性肿瘤根治手术中的应用.中国肿瘤临床与康复,2015,22(12):1456-1458.