Department of Obstetrics, Taizhou Hospital of Zhejiang Province, Taizhou, China.
Clin Appl Thromb Hemost. 2021 Jan-Dec;27:10760296211064276. doi: 10.1177/10760296211064276.
This study aimed to explore the effect of intraoperative blood salvage (autotransfusion) on coagulation function in the rescue of an obstetric hemorrhage.
A total of 65 pregnant women who were diagnosed with placenta previa in our Hospital and gave birth in the hospital were enrolled in the study. All the patients underwent thromboelastography, routine blood tests, and blood coagulation series + D-dimer before and within 30 min of the autologous blood transfusion. The differences in various indicators were evaluated.
(1) After the autotransfusion, the hemoglobin and neutrophil counts were significantly higher than beforehand, and the platelet count was significantly reduced; the differences were statistically significant (p < .05). (2) There were no significant differences in prothrombin time (PT), fibrinogen, and D-dimer levels before and after the autotransfusion ( > .05). The activated partial thromboplastin time after autotransfusion was shorter than that beforehand, and the difference was statistically significant ( < .05). (3) There were no significant differences in the R value, K value, α value, and MA value of the thromboelastogram before and after the autotransfusion ( > .05).
After the recovery autotransfusion, the hemoglobin of patients with a massive obstetric hemorrhage increased significantly, while the platelet count decreased, but the coagulation function and thromboelastogram did not change significantly, indicating the autotransfusion did not affect the coagulation function of the obstetric hemorrhage rescue. Thus, it would appear that intraoperative blood salvage can be safely used in the clinical rescue of massive hemorrhaging during cesarean section.
本研究旨在探讨术中血液回收（自体输血）对产科大出血抢救时凝血功能的影响。
选取我院收治的胎盘前置剖宫产术中大出血患者 65 例，所有患者均于自体血回输前及回输后 30min 内行血栓弹力图、常规血常规、凝血系列+D-二聚体检查，评估各项指标差异。
（1）自体血回输后血红蛋白、中性粒细胞计数明显高于回输前，血小板计数明显降低，差异有统计学意义（p<0.05）。（2）PT、纤维蛋白原、D-二聚体水平在回输前后比较差异无统计学意义（>0.05），回输后激活部分凝血活酶时间较回输前缩短，差异有统计学意义（<0.05）。（3）血栓弹力图 R 值、K 值、α 值、MA 值在回输前后比较差异无统计学意义（>0.05）。
产妇大量出血回收式自体输血后血红蛋白明显升高，血小板计数降低，但凝血功能及血栓弹力图变化不明显，提示自体输血不影响产科大出血抢救时的凝血功能，术中血液回收可安全应用于剖宫产术中大出血的临床抢救。
