分析术中自体输血对血清电解质的影响,剖宫产产妇的炎症反应和细胞免疫反应。这项研究是对2022年1月至2023年1月在我院接受剖宫产的60名妇女的回顾性研究。根据患者的输血方式将受试者分为2组。输血量的差异,输血量,血清电解质,炎症反应,细胞免疫功能,比较两组患者的凝血功能及预后。术中输血量,术后喂养时间,起床后的活动时间,观察组的身体恢复时间和住院时间均低于对照组,但观察组术中晶体输注量和胶体输注量均高于对照组(P<0.05)。观察组和对照组术前Ca2+浓度均低于同组,差异有统计学意义(P<0.05)。然而,观察组与对照组的Ca2+浓度比较差异无统计学意义(P>0.05)。术后1d,IL-1β,IL-6和粒细胞-巨噬细胞集落刺激因子(GM-CSF)均较高(P<0.05),观察组和对照组术前CD4+、CD4+/CD8+均低于同组(P<0.05)。IL-1β,与对照组比较,观察组IL-6、GM-CSF降低(P<0.05),CD3+,CD4+,观察组CD4+/CD8+较对照组升高(P<0.05)。产妇剖宫产术中自体输血和异体输血均可减轻炎性反应,对凝血无明显抑制作用,自体输血对细胞免疫反应的影响较小,在减轻炎症反应方面更有效,并显著改善预后,尽管输血后Ca2+浓度的变化需要注意。
Analyzing the effect of intraoperative autotransfusion on serum electrolytes, inflammatory response and cellular immune response in puerperae undergoing cesarean section. This study is a retrospective study of 60 women who underwent cesarean section in our hospital from January 2022 to January 2023. The subjects were divided into 2 groups according to the blood transfusion mode of the patients. The differences in blood transfusion volume, blood transfusion volume, serum electrolyte, inflammatory response, cellular immune function, coagulation function and prognosis were compared between the 2 groups. The intraoperative blood transfusion volume, postoperative feeding time, the activity time since getting out of bed, the time of physical recovery and hospital stay in the observation group were lower compared to those of the control group, but the intraoperative crystal infusion volume and the colloid infusion volume in the observation group were higher compared to those of the control group (P < .05). Ca2+ concentrations of the observation group and the control group were lower compared with those of their same groups before surgery (P < .05), however, there were no statistically significant differences in the comparison of the Ca2+ concentrations between the observation group and the control group (P > .05). At 1d postoperatively, IL-1β, IL-6 and granulocyte-macrophage colony-stimulating factor (GM-CSF) were all higher (P < .05) and CD3+, CD4+ and CD4+/CD8+ were all lower (P < .05) in the observation group and the control group compared with those of their same groups before surgery. The IL-1 β, IL-6, and GM-CSF of the observation group were decreased compared to those of the control group (P < .05) and CD3+, CD4+, CD4+/CD8+ of the observation group were elevated compared to those of the control group (P < .05). Both autotransfusion and allogeneic blood transfusions during maternal cesarean section can attenuate the inflammatory response and have no significant inhibition of coagulation, and autotransfusion have less effect on the cellular immune response, are more effective in attenuating the inflammatory response, and significantly improve prognosis, although changes in Ca2+ concentration after transfusion require attention.