严重血型不合胎儿的血管内交换及大剂量输血

Intravascular exchange and bolus transfusion in the severely isoimmunized fetus.

作者信息

Ronkin S, Chayen B, Wapner R J, Blocklinger A, Davis G, Roberts N, Hux C H

机构信息

Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19107.

出版信息

Am J Obstet Gynecol. 1989 Feb;160(2):407-11. doi: 10.1016/0002-9378(89)90459-6.

DOI:10.1016/0002-9378(89)90459-6

PMID:2492764

Abstract

Eight Rh-sensitized fetuses, between 21 weeks 2 days and 35 weeks of gestation, received 31 intravascular transfusions (13 exchange and 18 bolus) and one intraperitoneal transfusion under ultrasonographic guidance. The interval between transfusions was 13.4 +/- 4.7 days. Posttransfusion hematocrit dropped at a rate of 1.0% +/- 0.6% per day. Procedure time for the bolus transfusion was shorter than for the exchange transfusion (t test, p less than 0.001). Bleeding from the puncture site complicated 10 of the 31 intravascular transfusions, without apparent maternal or fetal consequences. Fetuses were delivered between 33 and 36 weeks of gestation, after lung maturity was achieved.

摘要

8例妊娠21周2天至35周的Rh致敏胎儿在超声引导下接受了31次血管内输血（13次换血和18次推注）及1次腹腔内输血。输血间隔时间为13.4±4.7天。输血后血细胞比容以每天1.0%±0.6%的速度下降。推注输血的操作时间短于换血输血（t检验，p<0.001）。31次血管内输血中有10次出现穿刺部位出血，未对母体或胎儿造成明显影响。胎儿在肺成熟后于妊娠33至36周分娩。