CAJ | 학술논문

目的：探讨等容稀释性（acute normovolemic hemodilution ANH）自体输血在 Rh（D）阴性孕妇分娩过程中的安全性。方法：对孝感市医院产科2007年7月至2011年10月住院的34例 Rh（D）阴性孕妇在分娩前采集自体血，同时补充晶体液和/或胶体液，采集过程中监测孕妇生命体征及胎心，34例孕妇均于数小时内结束生产，生产后立即将自体血回输。对照组为同期住院生产的 Rh（D）阳性孕妇28例，对照组未自体输血也未异体输血。测定两组孕妇入院时及生产后两天血常规并进行对比。结果：两组孕妇生产前血常规各项指标无统计学差异，Rh（D）阴性孕妇分娩前和自体血回输后红细胞（RBC）、血红蛋白（HB）、红细胞压积（HCT）、血小板（PLT）比较差异无统计学意义；Rh（D）阳性孕妇分娩后红细胞（RBC）、血红蛋白（HB）、红细胞压积（HCT）较分娩前下降有统计学意义。34例 Rh（D）阴性孕妇均未发生采血及回输血不良反应，新生儿5分钟 Apgar 评分均9-10分。结论：ANH 自体输血能解决 Rh（D）阴性血源稀缺难题，在应对 Rh（D）阴性孕妇产后出血时发挥重要作用，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：탐토등용희석성（acute normovolemic hemodilution ANH）자체수혈재 Rh（D）음성잉부분면과정중적안전성。방법：대효감시의원산과2007년7월지2011년10월주원적34례 Rh（D）음성잉부재분면전채집자체혈，동시보충정체액화/혹효체액，채집과정중감측잉부생명체정급태심，34례잉부균우수소시내결속생산，생산후립즉장자체혈회수。대조조위동기주원생산적 Rh（D）양성잉부28례，대조조미자체수혈야미이체수혈。측정량조잉부입원시급생산후량천혈상규병진행대비。결과：량조잉부생산전혈상규각항지표무통계학차이，Rh（D）음성잉부분면전화자체혈회수후홍세포（RBC）、혈홍단백（HB）、홍세포압적（HCT）、혈소판（PLT）비교차이무통계학의의；Rh（D）양성잉부분면후홍세포（RBC）、혈홍단백（HB）、홍세포압적（HCT）교분면전하강유통계학의의。34례 Rh（D）음성잉부균미발생채혈급회수혈불량반응，신생인5분종 Apgar 평분균9-10분。결론：ANH 자체수혈능해결 Rh（D）음성혈원희결난제，재응대 Rh（D）음성잉부산후출혈시발휘중요작용，대잉부급태인균무불량영향，시일충안전、유효적수혈방식。
To explor the security of acute normovolemic hemodilution autologous transfusion during Rh(D)-nega-tive pregnant childbirth.Methods:The 34 cases of Rh(D)-negative pregnant from July 2007 to October 201 1 in Xiao Gan Central Hospital were collected venous blood before giving birth.At the same time,they were supplied with colloidal fluid and /or crystal fluid.In the process of blood collection,monitor the situation of these pregnant and the fetal heart rate.All these 34 Rh(D)-negative pregnant gave birth after several hours.After delivery,the venous blood samples were immediate-ly transfused respectively.As control group,28 cases of Rh(D)-positive pregnant did not have autologous transfusion or al-logeneic transfusion.We compared the bloods test results of the two groups before and after delivery.Results:There is no statistical difference in these two groups before they gave birth.And there is no statistical difference in RBC,HB,HCT, PLT of the Rh(D)-negative pregnant before they gave birth and after the blood transfusion.While the level of RBC,HB, HCT are decreased in Rh(D)-positive prengant after they gave birth.In addition,there is no adverse effect to the 34 Rh (D)-negative pregnant during blood collecting or transfusion and the fifth minute Apgar of neonatus were 9 -1 0.Conclu-sions:ANH transfusion can solve the problem of Rh(D)blood scarcity and plays an important role during postpartum hemor-rhage without adverse effect.It is a safe and effective way of blood transfusion.