Blood Transfusion Department, Yichang Central People's Hospital, Yichang, Hubei, China.
Gynecology and Obstetrics, Yichang Maternity& Child Healthcare Hospital, Yichang, Hubei, China.
Medicine (Baltimore). 2024 May 24;103(21):e38200. doi: 10.1097/MD.0000000000038200.
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.
分析剖宫产术中自体输血对产妇血清电解质、炎症反应和细胞免疫反应的影响。本研究是对 2022 年 1 月至 2023 年 1 月在我院行剖宫产术的 60 例产妇进行的回顾性研究。根据患者的输血方式，将研究对象分为两组。比较两组患者的输血量、输血量、血清电解质、炎症反应、细胞免疫功能、凝血功能和预后的差异。观察组术中输血量、术后喂养时间、下床活动时间、身体恢复时间和住院时间均低于对照组，但观察组术中晶体液输注量和胶体液输注量高于对照组（P<.05）。观察组和对照组的 Ca2+浓度均低于术前同组（P<.05），但观察组和对照组的 Ca2+浓度比较差异无统计学意义（P>.05）。术后 1d，观察组和对照组的 IL-1β、IL-6 和粒细胞-巨噬细胞集落刺激因子（GM-CSF）均升高（P<.05），CD3+、CD4+和 CD4+/CD8+均降低（P<.05），与术前同组相比。观察组的 IL-1β、IL-6 和 GM-CSF 低于对照组（P<.05），CD3+、CD4+和 CD4+/CD8+高于对照组（P<.05）。剖宫产术中自体输血和异体输血均可减轻炎症反应，对凝血功能无明显抑制作用，且自体输血对细胞免疫反应的影响较小，对炎症反应的抑制作用更强，显著改善预后，但输血后 Ca2+浓度的变化值得关注。
