CAJ | 학술논문

目的：探讨急性等容血液稀释(ANH)在完全性前置胎盘合并胎盘植入剖宫产手术中应用的有效性和安全性。方法将52例需剖宫产终止妊娠的完全性前置胎盘合并胎盘植入的产妇随机双盲分为三组：A 组在术前进行 ANH,B 组在术前进行急性高容血液稀释(AHH),C 组术前无特殊处理。记录三组产妇术中总出血量、异体血输注例数、术前、术后2 h 血常规及三组新生儿1、5 min Apgar评分和脐动脉血血气。结果 A、B 组产妇急性血液稀释后血气分析差异无统计学意义。A 组输注异体血例数明显少于 B、C 组(P <0.05),术后2 h 产妇 Hb、Hct、Plt 明显高于 B、C 组(P <0.05),B、C 组差异无统计学意义；三组新生儿1、5 min Apgar 评分和脐动脉血气分析差异无统计学意义。结论 ANH自体输血对孕妇及胎儿均无不良影响,是一种安全、有效的输血方式。
목적：탐토급성등용혈액희석(ANH)재완전성전치태반합병태반식입부궁산수술중응용적유효성화안전성。방법장52례수부궁산종지임신적완전성전치태반합병태반식입적산부수궤쌍맹분위삼조：A 조재술전진행 ANH,B 조재술전진행급성고용혈액희석(AHH),C 조술전무특수처리。기록삼조산부술중총출혈량、이체혈수주례수、술전、술후2 h 혈상규급삼조신생인1、5 min Apgar평분화제동맥혈혈기。결과 A、B 조산부급성혈액희석후혈기분석차이무통계학의의。A 조수주이체혈례수명현소우 B、C 조(P <0.05),술후2 h 산부 Hb、Hct、Plt 명현고우 B、C 조(P <0.05),B、C 조차이무통계학의의；삼조신생인1、5 min Apgar 평분화제동맥혈기분석차이무통계학의의。결론 ANH자체수혈대잉부급태인균무불량영향,시일충안전、유효적수혈방식。
Objective To investigate the efficacy and safety of acute normovolemic hemodilu-tion for pregnant women with total placenta pravia and accreta.Methods Fifty-two pregnant women with placenta praevia and accreta were randomly divided into three groups.Groups A and B received ANH or AHH before the operation while group C received the normal treatment.The total blood loss,transfusion of allogeneic blood and preoperative and postoperative routine blood test were recor-ded;the infants’umblical artery blood samples were taken immediately after birth,and 1 min,5 min Apgar scores and the blood gas was analyzied.Results There were no significant difference in the general condition,operation duration,blood loss among the three groups;the transfusion of allogeneic blood in groups B and C were much more than group A (P <0.05);the postoperative hemoglobin and hematocrit and the count of plateletsin in group A were better than groups B and C (P <0.05),while there were no statistically difference between groups B and C;there were not only seldom difference in the Apgar scores of 1 min and 5 min,but also barely change in the blood gas analysis of umbilical ar-tery in new borns from the three groups.Conclusion ANH could play an important role in the pre-vention of postpartum hemorrhage without doing any harm to the mother and infant.