Blood Transfusion, Autologous

输血,自体
  • 文章类型: Case Reports
    背景技术血细胞保护者,或者自体输血系统,用于收集,wash,并返回从手术患者收集的自体血液。该报告描述了一名55岁的男子,他在体外循环下接受了二尖瓣和主动脉瓣联合置换手术,并在术中和术后使用血细胞保护者进行自体输血后获得了成功的结果。个案报告病人因宗教良心原因不接受输血,病情危重,接受姑息治疗。他需要二尖瓣和主动脉瓣联合置换手术。手术在术中和术后使用细胞保存器(SorinXtra自体输血系统)进行24小时,为了解决这个具有挑战性的案件,从技术和伦理的角度来看。术中回收的红细胞体积为1430mL,血细胞比容水平为40%,和690毫升,血细胞比容为35%,在术后期间。因此,回收了大量的自体血液。自体输血为患者带来了极好的临床结果,他在术后第九天出院。结论我们可以得出结论,在心脏手术中使用血细胞保护者,在术中和术后期间,导致维持足够的血红蛋白和血细胞比容水平,术后无感染,患者迅速完全恢复。因此,血细胞保护者的使用保证了个人安全拒绝血液制品的自主权,具有良好的临床效果,并且不依赖同种异体输血。
    BACKGROUND A blood cell saver, or autotransfusion system, is used to collect, wash, and return autologous blood collected from the surgical patient. This report describes a 55-year-old man who underwent combined mitral and aortic valve replacement surgery with cardiopulmonary bypass and had a successful outcome following intraoperative and postoperative autologous blood transfusion using a blood cell saver. CASE REPORT The patient did not accept blood transfusion for reasons of religious conscience and was in a critical condition, receiving palliative care. He needed combined mitral and aortic valve replacement surgery. The surgery was conducted using a cell saver (Sorin Xtra Autotransfusion System) in the intraoperative and postoperative periods for 24 h, to resolve this challenging case, from a technical and ethical point of view. The volume of red blood cells recovered intraoperatively was 1430 mL, with a hematocrit level of 40%, and 690 mL, with a hematocrit of 35%, in the postoperative period. Therefore, a significant volume of autologous blood was recovered. The autologous blood transfusion resulted in an excellent clinical outcome for the patient, who was discharged on the ninth postoperative day. CONCLUSIONS We can conclude that the use of a blood cell saver in cardiac surgery, in both intra- and postoperative periods, resulted in the maintenance of adequate hemoglobin and hematocrit levels, no infection postoperatively, and rapid and complete recovery of the patient. Thus, the use of the blood cell saver guaranteed the individual\'s autonomy to refuse blood products safely, with good clinical results, and without dependence on allogeneic blood transfusions.
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  • 文章类型: Journal Article
    目的:确定犬科手术患者在引入细胞抢救装置(CSD)后接受的同源输血次数,需要输血的手术趋势,和输血反应的发生率。
    方法:回顾性研究。
    方法:单一转诊医院。
    方法:所有在单个中心进行手术的狗(2015年11月至2021年2月)。
    方法:接受手术治疗的狗的医疗记录,包括接受自体或同源输血的人,被审查了。手术患者是基线人群,并在该人群中比较2个输血组以分析趋势。
    结果:共有37只和86只狗接受了自体和同源输血,分别。每月输血总数呈上升趋势。在获得CSD之前或之后,未观察到每月同源输血次数的显着增加。每月手术总数亦有上升趋势,包括出血风险较高的患者。接受同源输血的狗与输血反应一致的临床体征发生率较高(6.98%)。
    结论:随着CSD的引入,自体输血呈上升趋势。手术病例量大,出血风险高的医院使用CSD可能会减少对外包血液制品的需求。该设备可以导致对日益稀缺的资源的更负责任的使用,并降低狗的输血反应的风险。
    OBJECTIVE: To determine the number of homologous blood transfusions received by canine surgical patients after introducing a cell salvage device (CSD), trends in surgeries requiring blood transfusion, and the incidence of transfusion reactions.
    METHODS: Retrospective study.
    METHODS: Single referral hospital.
    METHODS: All dogs having surgery at a single center (November 2015 to February 2021).
    METHODS: Medical records of dogs having surgical treatment, including those that received either an autologous or homologous blood transfusion, were reviewed. The surgical patients were the baseline population, and the 2 transfusion groups were compared within this population to analyze the trends.
    RESULTS: A total of 37 and 86 dogs received autologous and homologous blood transfusions, respectively. There was an upward trend in the number of total monthly blood transfusions. No significant increase in the monthly number of homologous transfusions was observed before or after acquisition of the CSD. There was also an upward trend in total monthly surgeries, including those with higher risks of hemorrhage. Dogs receiving homologous blood transfusions had a higher incidence of clinical signs consistent with transfusion reactions (6.98%).
    CONCLUSIONS: An upward trend in autologous blood transfusions was seen with the introduction of a CSD. Hospitals with large surgical caseloads at high risk of hemorrhage may see a decreased need for outsourced blood products with the use of the CSD. The device can lead to a more responsible use of an increasingly scarce resource and decrease the risk of a blood transfusion reaction in dogs.
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  • 文章类型: Journal Article
    背景:因为外上髁炎是一种常见的肌肉骨骼疾病,会影响前臂的伸肌肌腱,有效的治疗方法应该逆转退化并促进再生。本研究旨在比较自体血(AB)注射的疗效,皮质类固醇(CS)注射液,联合注射治疗外上髁炎(LE),假设联合治疗方法可以立即缓解症状并降低复发率。
    方法:将120例诊断为外上髁炎的患者系统地分布在三个不同的治疗性注射组中。AB组给予1ml自体静脉血与2ml2%盐酸丙胺卡因混合。CS类别的参与者给予1ml40mg醋酸甲泼尼龙与2ml2%盐酸丙胺卡因混合。同时,联合组患者接受1ml自体静脉血和40mg醋酸甲泼尼龙以及1ml2%盐酸丙胺卡因的混合物.在接受各自的注射之前,对所有参与者进行了全面评估。随后在第15、30和90天使用患者评定的网球肘评估(PRTEE)和手握力(HGS)的测量指标进行随访评估。
    结果:一名患者从联合组中退出,119名患者完成了试验。随访期间无并发症发生。到第15天,所有组都显示出PRTEE的显着改善,CS显示最明显的减少(p=0.001)。然而,CS的获益在第30天恶化,到第90天进一步恶化.AB组和AB+CS组表现出持续的改善,AB+CS揭示了最有效的治疗方法,在97.4%的患者中实现了临床上显着的改善。改进的HGS与功能增强并行,因为它在AB和AB+CS组中更显著(p=0.001),证实了这些治疗的持续益处。
    结论:该研究得出结论,虽然AB和CS单独提供不同的好处,组合AB+CS方法优化治疗结果,提供快速和持续的功能改善,复发率较低。这些发现具有重要的临床意义,建议一个平衡的,增强LE患者康复的多模式治疗策略。
    方法:随机临床试验,一级证据。
    背景:NCT06236178。
    BACKGROUND: Because lateral epicondylitis is a common musculoskeletal disorder that affects the forearm\'s extensor tendons, an effective therapeutic approach should reverse the degeneration and promote regeneration. This study aimed to compare the efficacies of autologous blood (AB) injection, corticosteroid (CS) injection, and a combined injection of both in treating lateral epicondylitis (LE), hypothesizing that the combined approach might offer immediate symptom resolution and a lower recurrence.
    METHODS: A total of 120 patients diagnosed with lateral epicondylitis were systematically distributed among three distinct therapeutic injection groups. Those in the AB group were administered 1 ml of autologous venous blood mixed with 2 ml of 2% prilocaine HCl. Participants in the CS category were given 1 ml of 40 mg methylprednisolone acetate mixed with 2 ml of 2% prilocaine HCl. Meanwhile, patients in the combined group received a mixture containing 1 ml each of autologous venous blood and 40 mg methylprednisolone acetate along with 1 ml of 2% prilocaine HCl. Prior to receiving their respective injections, a comprehensive assessment of all participants was carried out. Follow-up assessments were subsequently conducted on days 15, 30, and 90 utilizing metrics of the patient-rated tennis elbow evaluation (PRTEE) and measurements of hand grip strength (HGS).
    RESULTS: One patient dropped out from the combined group, and 119 patients completed the trial. No complications were recorded during the course of follow-up. By day 15, all groups had demonstrated significant PRTEE improvement, with CS showing the most pronounced reduction (p = 0.001). However, the benefits of CS had deteriorated by day 30 and had deteriorated further by day 90. The AB and AB + CS groups demonstrated sustained improvement, with AB + CS revealing the most effective treatment, achieving a clinically significant improvement in 97.4% of the patients. The improved HGS parallelled the functional enhancements, as it was more substantial in the AB and AB + CS groups (p = 0.001), corroborating the sustained benefits of these treatments.
    CONCLUSIONS: The study concluded that while AB and CS individually offer distinct benefits, a combined AB + CS approach optimizes therapeutic outcomes, providing swift and sustained functional improvement with a lower recurrence rate. These findings have substantial clinical implications, suggesting a balanced, multimodal treatment strategy for enhanced patient recovery in LE.
    METHODS: Randomized clinical trial, level 1 evidence.
    BACKGROUND: NCT06236178.
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  • 文章类型: Journal Article
    背景:气胸是CT引导下经皮经胸肺活检(CT-PTLB)后最常见的并发症。许多研究报道,活检针退出期间注射自体血补片(ABP)可以降低CT-PTLB后气胸和胸管插入率,但结果值得商榷。本系统评价和荟萃分析的目的是综合有关接受CT-PTLB的患者的ABP手术疗效的证据。
    方法:在Pubmed,Embase和WebofScience数据库。纳入标准是评估CT-PTLB后ABP与气胸和/或胸管插入率之间关系的研究。根据研究类型进行亚组分析,还进行了肺气肿状况和应用的ABP技术。计算比值比(OR)和95%置信区间(CI)以检查风险关联。
    结果:共10项研究,包括3874例患者,符合分析条件。我们的分析表明,ABP减少了气胸(发病率:20.0%vs.27.9%,OR=0.67,95%CI=0.48-0.66,P<0.001)和胸管插入率(发生率:4.0%vs.8.0%,CT-PTLB后OR=0.47,95%CI=0.34-0.65,P<0.001)。根据研究类型(RCT或回顾性研究)进行亚组分析,肺气肿状态(有或没有肺气肿),我们还进行了应用ABP技术(凝结或非凝结ABP),我们发现ABP降低了所有亚组的气胸和胸管插入率.
    结论:我们的研究表明,使用ABP是降低CT-PTLB后气胸和胸管插入率的有效技术。
    BACKGROUND: Pneumothorax is the most frequent complication after CT-guided percutaneous transthoracic lung biopsy (CT-PTLB). Many studies reported that injection of autologous blood patch (ABP) during biopsy needle withdrawal could reduce the pneumothorax and chest tube insertion rate after CT-PTLB, but the result is debatable. The aim of this systematic review and meta-analysis is to synthesize evidence regarding the efficacy of ABP procedure in patients receiving CT-PTLB.
    METHODS: Eligible studies were searched in Pubmed, Embase and Web of Science databases. The inclusion criteria were studies that assessed the relationship between ABP and the pneumothorax and/or chest tube insertion rate after CT-PTLB. Subgroup analyses according to study type, emphysema status and ABP technique applied were also conducted. Odds ratio (OR) with 95% confidence interval (CI) were calculated to examine the risk association.
    RESULTS: A total of 10 studies including 3874 patients were qualified for analysis. Our analysis suggested that ABP reduced the pneumothorax (incidence: 20.0% vs. 27.9%, OR = 0.67, 95% CI = 0.48-0.66, P < 0.001) and chest tube insertion rate (incidence: 4.0% vs. 8.0%, OR = 0.47, 95% CI = 0.34-0.65, P < 0.001) after CT-PTLB. Subgroup analysis according to study type (RCT or retrospective study), emphysema status (with or without emphysema), and ABP technique applied (clotted or non-clotted ABP) were also performed and we found ABP reduced the pneumothorax and chest tube insertion rate in all subgroups.
    CONCLUSIONS: Our study indicated that the use of ABP was effective technique in reducing the pneumothorax and chest tube insertion rate after CT-PTLB.
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  • 文章类型: Journal Article
    背景:研究使用计算机断层扫描(CT)指导注射自体血液以定位孤立的肺结节的气胸的危险因素。
    方法:在莆田市第一医院,回顾性分析2019年11月至2023年3月92例单发肺小结节病例。每次手术前,自体血液注射,以及每个病例的并发症,如气胸和肺出血,被记录下来。病人性,年龄,定位时的位置,和结节类型,尺寸,location,并考虑了与内脏胸膜的距离。同样,胸壁的厚度,针肺接触的深度和持续时间,定位过程的长度,并注意到与患者定位相关的并发症。采用物流单因素和多因素变量分析确定气胸的危险因素。将多因素物流分析纳入最终的列线图预测模型进行建模,并建立了一个列线图。
    结果:Logistics分析提示结节大小和针体与肺组织的接触深度是气胸的独立危险因素。
    结论:定位后气胸的相关因素是结节较小和针体与肺组织接触较深。
    BACKGROUND: To investigate the risk factors of pneumothorax of using computed tomography (CT) guidance to inject autologous blood to locate isolated lung nodules.
    METHODS: In the First Hospital of Putian City, 92 cases of single small pulmonary nodules were retrospectively analyzed between November 2019 and March 2023. Before each surgery, autologous blood was injected, and the complications of each case, such as pneumothorax and pulmonary hemorrhage, were recorded. Patient sex, age, position at positioning, and nodule type, size, location, and distance from the visceral pleura were considered. Similarly, the thickness of the chest wall, the depth and duration of the needle-lung contact, the length of the positioning procedure, and complications connected to the patient\'s positioning were noted. Logistics single-factor and multi-factor variable analyses were used to identify the risk factors for pneumothorax. The multi-factor logistics analysis was incorporated into the final nomogram prediction model for modeling, and a nomogram was established.
    RESULTS: Logistics analysis suggested that the nodule size and the contact depth between the needle and lung tissue were independent risk factors for pneumothorax.
    CONCLUSIONS: The factors associated with pneumothorax after localization are smaller nodules and deeper contact between the needle and lung tissue.
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  • 文章类型: Journal Article
    The results of a prospective open cohort study of the use of platelet-rich plasma (platelet-rich plasma - PRP) in patients with chronic pharyngitis during the exacerbation of the disease are presented.
    OBJECTIVE: To evaluate the clinical efficacy of autologous PRP in the treatment of chronic pharyngitis.
    METHODS: Autologous PRP was injected into the posterior pharyngeal wall as a course of endopharyngeal blockages as part of the complex therapy of chronic pharyngitis. Patients in the control group received standard therapy, without the use of autologous PRP. The effectiveness of the studied technique was evaluated by statistical analysis of the intensity of symptoms of the disease, determined by patients throughout the entire period of treatment in the patient\'s diary, as well as by analyzing data from mass spectrometry of microbial markers and bacteriological examination of the pharyngeal mucosa, collected at the beginning of the study and 14 days after completion of the course of therapy.
    CONCLUSIONS: The use of a course of endopharyngeal blockades with autologous platelet-rich plasma as part of the complex therapy of chronic pharyngitis, according to our estimates, provides a significant effect in the form of higher rates of reduction in the severity of symptoms of the disease, a significant reduction in the number of microorganisms deviating from the reference values (by 2 times or more), a decrease in the duration of the disease compared with the control group.
    Представлены результаты проспективного открытого когортного исследования применения обогащенной тромбоцитами плазмы (platelet-rich plasma — PRP) у пациентов с хроническим фарингитом в период обострения заболевания.
    UNASSIGNED: Оценить клиническую эффективность применения аутологичной PRP при лечении хронического фарингита.
    UNASSIGNED: Аутологичную PRP вводили в заднюю стенку глотки в виде курса эндофарингеальных блокад в составе комплексной терапии хронического фарингита. Пациенты контрольной группы получали стандартную терапию, без применения аутологичной PRP. Оценка эффективности изучаемой методики проведена путем статистического анализа интенсивности симптомов заболевания, определяемой больными на протяжении всего периода лечения в дневнике пациента, а также посредством анализа данных масс-спектрометрии микробных маркеров и бактериологического исследования отделяемого слизистой оболочки глотки, собранного в начале исследования и спустя 14 дней после завершения курса терапии.
    UNASSIGNED: Использование курса эндофарингеальных блокад с аутологичной плазмой, обогащенной тромбоцитами, в составе комплексной терапии хронического фарингита, по нашим оценкам, обеспечивает значимый эффект в виде более высоких темпов уменьшения выраженности симптомов заболевания, существенного уменьшения количества микроорганизмов, отклоняющегося от референсных значений (в 2 раза и более), уменьшения длительности заболевания по сравнению с группой контроля.
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  • 文章类型: Journal Article
    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.
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  • 文章类型: Journal Article
    背景:由于挽救过程中疾病传播的潜在风险,在肿瘤手术中使用自体输血有些争议。另一方面,自体输血可以防止同种异体输血的潜在负面影响,减少宝贵资源的使用。
    方法:本研究纳入了在2015年12月至2019年6月期间在我们机构接受肿瘤肝脏手术的106例成年患者。患者分为两组:CellSaver®组(2018年1月至2019年6月手术)和对照组(2015年12月至2017年12月手术)。CellSaver®装置存在于CellSaver®组的手术室中,如果发生一定量的失血,则重新输血。数据分析侧重于输血需求等结果,总生存率,无复发生存率,血红蛋白水平,住院,和并发症。患者记录提供了人口统计学的相关信息,手术细节,病理学,以及两组的结果。
    结果:发现自体输血可减少所需的血量(4.0单位(对照组)与0.4单位(CellSaver®组)P=0.029。Kaplan-Meier曲线显示,总生存期471.6天(CellSaver®组)与468.3天(对照组)(P=0.219)和488.9天(CellSaver®组)与487.2天(对照组)(P=0.993)以及无病生存期(P=0.553)和(P=0.735)。无论肿瘤类型如何,总生存期与对照组相似(485.4dvs.481.9d)(P=0.503)。小肝切除术的生存率显着降低(516.0dvs.517.4d)(P=0.050)在CellSaver®组中,大型肝切除术在总生存率上没有差异(470.2dvs.466.4d)(P=0.868)。在接受自体输血的患者与未接受自体输血的患者之间未发现对疾病复发的影响。
    结论:在肝脏肿瘤手术中不应该避免使用CellSaver®。CellSaver®用于主要肝切除术可能更有益,因为CellSaver®组的OS显着降低,用于接受较小肝切除术的患者。需要进一步的研究来解释这种矛盾的结果。尽管如此,在自体输血中使用CellSaver®可以减少宝贵资源的使用以及与同种异体输血相关的风险。
    BACKGROUND: The use of autologous blood transfusions in oncologic surgeries is somewhat controversial due to the potential risk of disease dissemination through the salvage process. On the other hand, autologous blood transfusion can prevent the potential negative effects of allogenic blood transfusions and reduce use of valuable resources.
    METHODS: This study included 106 adult patients who underwent oncologic liver surgery at our institution between December 2015 and June 2019. The patients were divided into two groups: the Cell Saver group (operated between January 2018 and June 2019) and the control group (operated between December 2015 and December 2017). The Cell Saver device was present in the operating room for the Cell Saver group, and blood was retransfused if a certain amount of blood loss occurred. Data analysis focused on outcomes such as blood transfusion requirements, overall survival, recurrence-free survival, hemoglobin levels, hospital stay, and complications. Patient records provided relevant information on demographics, surgery details, pathology, and outcomes for both groups.
    RESULTS: Autologous blood transfusion was found to reduce the amount of blood units needed (4.0 units (control group) versus 0.4 units (Cell Saver group) P =0.029. Kaplan-Meier curves showed no difference for both overall survival 471.6 days (Cell Saver group) versus 468.3 days (control group) ( P =0.219) and 488.9 days (Cell Saver group) versus 487.2 days (control group) ( P =0.993) and disease-free survival ( P =0.553) and ( P =0.735) for primary hepatic tumors and hepatic metastasis respectively between the Cell Saver and control groups. Overall survival regardless of the type of tumor was similar to the control group (485.4 days vs. 481.9 days) ( P =0.503). Survival was significantly lower for minor hepatectomies (516.0 days vs. 517.4 days) ( P =0.050) in the Cell Saver group, major hepatectomies showed no difference in overall survival (470.2 days vs. 466.4 days) ( P =0.868). No impact on disease recurrence was found between patients who received autologous blood transfusions versus those who did not.
    CONCLUSIONS: The use of Cell Saver should not be avoided in oncologic surgeries of the liver. Use of Cell Saver for major hepatectomies might be more beneficial as OS was significantly lower for the Cell Saver group for patients who underwent minor hepactomies. Further research is needed to explain this conflicting result. Nonetheless, the use of Cell Saver in autologous blood transfusions can reduce the use of valuable resources and the risks associated with allogenic blood transfusions.
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  • 文章类型: Journal Article
    背景:产后贫血是围产期发病率的重要因素。尚未研究低风险病例中细胞回收的利用及其对产后贫血的影响。因此,我们旨在研究常规剖宫产中自体输血/细胞回收对术后血细胞比容和贫血的影响。
    方法:回顾性队列研究来自大型学术中心的灌注数据库,该中心的细胞抢救由产科团队自行决定。获得了99名患者的数据。所有患者均计划在分娩和分娩楼层进行选择性剖宫产。该队列中有30名患者在手术后输入自体血的情况下获得了细胞抢救。程序前血红蛋白/血细胞比容测量是随着产后第一天收集的产后样本获得的。
    结果:返回细胞抢救患者的血液中位数为250mL[206-250]。细胞抢救患者的血细胞比容变化明显小于对照组(-1.85[-3.87,-0.925]vs-6.4[-8.3,-4.75];p<0.001)。细胞抢救治疗组术后发生新贫血的几率降低了74%,与对照组相比(OR=0.26(0.07-0.78);p=0.028)讨论:尽管平均失血更多,获得细胞抢救的患者术后HCT较高,减少产后贫血,输血相关并发症无差异。常规剖宫产术中细胞回收的利用值得进一步研究。
    BACKGROUND: Postpartum anemia is a significant contributor to peripartum morbidity. The utilization of cell salvage in low risk cases and its impact on postpartum anemia has not been investigated. We therefore aimed to examine the impact of autologous blood transfusion/cell salvage in routine cesarean delivery on postoperative hematocrit and anemia.
    METHODS: Retrospective cohort study from a perfusion database from a large academic center where cell salvage is performed at the discretion of the obstetrical team. Data from 99 patients was obtained. All patients were scheduled elective cesarean deliveries that took place on the labor and delivery floor. Thirty patients in the cohort had access to cell salvage where autologous blood was transfused after surgery. Pre-procedural hemoglobin/hematocrit measurements were obtained along will postpartum samples that were collected on post-partum day one.
    RESULTS: The median amount of blood returned to cell salvage patients was 250 mL [206-250]. Hematocrit changes in cell salvage patients was significantly smaller than controls (-1.85 [-3.87, -0.925] vs -6.4 [-8.3, -4.75]; p < 0.001). The odds of developing new anemia following surgery were cut by 74% for the cell salvage treatment group, compared to the odds for the control group (OR = 0.26 (0.07-0.78); p = 0.028) DISCUSSION: Despite losing more blood on average, patients with access to cell salvage had higher postoperative HCT, less postpartum anemia, and no difference in complications related to transfusion. The utilization of cell salvage for routine cesarean delivery warrants further research.
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