切换至 "中华医学电子期刊资源库"

中华妇幼临床医学杂志(电子版) ›› 2018, Vol. 14 ›› Issue (05) : 617 -620. doi: 10.3877/cma.j.issn.1673-5250.2018.05.021

所属专题: 文献

综述

术中自体血液回输在产科中应用的研究进展
李海冰1   
  1. 1. 201204 上海,同济大学附属第一妇婴保健院麻醉科
  • 收稿日期:2018-04-08 修回日期:2018-06-19 出版日期:2018-10-01

Research progress of intraoperative cell salvage in obstetrics

Haibing Li1   

  1. 1. Department of Anesthesiology, First Maternity and Infant Hospital Affiliated to Tongji University, Shanghai 201204, China
  • Received:2018-04-08 Revised:2018-06-19 Published:2018-10-01
  • About author:
    Corresponding author: Liu Zhiqiang, Email:
  • Supported by:
    Joint Key Project of Heath and Family Planning Commission of Pudong New District in Shanghai(PW2016D-10); Medical Guiding Project of Shanghai Science and Technology Committee(16411967400)
引用本文:

李海冰. 术中自体血液回输在产科中应用的研究进展[J]. 中华妇幼临床医学杂志(电子版), 2018, 14(05): 617-620.

Haibing Li. Research progress of intraoperative cell salvage in obstetrics[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2018, 14(05): 617-620.

术中自体血液回输是减少异体血输注的策略之一。20世纪70年代之前,为避免羊水栓塞或母体免疫反应,术中自体血液回输在产科手术中几乎被禁用。直至近年,白细胞滤器(LDF)的应用,术中自体血液回输才得以应用于产科。经自体血液回收仪(cell saver)处理和LDF过滤的产科术中回收自体血液中,胎儿鳞状细胞水平与胎盘剥离后的母体静脉血基本一致,并且迄今为止暂无因术中自体血液回输导致羊水栓塞的相关文献报道。对于术前预期血源紧张的大出血产科患者,可以考虑采用术中自体血液回输技术。笔者拟对术中自体血液回输在产科中中应用的研究进展进行综述。

Intraoperative cell salvage is one of the strategies to avoid allogeneic blood transfusion. Before 1970s, in order to avoid amniotic fluid embolism or maternal immune response, intraoperative cell salvage was almost forbidden in obstetric operations. Intraoperative cell salvage was applied to obstetric operations until the application of leukocyte depletion filter (LDF) in recent years. The level of fetal squamous cells in autologous blood treated with cell saver and filtered by LDF is basically the same as that of maternal vein blood after placenta stripping. So far, there are no definite cases of amniotic fluid embolism due to intraoperative cell salvage reported. For obstetric patients with bleeding who are expected to have a tight blood source, intraoperative cell salvage may be considered. This article mainly reviews research progress of intraoperative cell salvage in obstetrics.

[1]
Waters JH,Biscotti C,Potter PS, et al. Amniotic fluid removal during cell salvage in the cesarean section patient [J]. Anesthesiology, 2000, 92(6): 1531-1536.
[2]
Milne ME,Yazer MH,Waters JH. Red blood cell salvage during obstetric hemorrhage [J]. Obstet Gynecol, 2015, 125(4): 919-923.
[3]
Rudra P,Basak S. Coagulopathy during intraoperative cell salvage in a patient with major obstetric haemorrhage [J]. Br J Anaesth, 2011, 106(2): 280-281.
[4]
Rollins KE,Trim NL,Luddington RJ, et al. Coagulopathy associated with massive cell salvage transfusion following aortic surgery [J]. Perfusion, 2012, 27(1): 30-33.
[5]
Zheng J,Du L,Du G, et al. Coagulopathy associated with cell salvage transfusion following cerebrovascular surgery [J]. Pak J Med Sci, 2013, 29(6): 1459-1461.
[6]
Kudo H,Fujita H,Hanada Y, et al. Cytological and bacteriological studies of intraoperative autologous blood in neurosurgery [J]. Surg Neurol, 2004, 62(3): 195-199; discussion 199-200.
[7]
Shindo S,Matsumoto H,Kubota K, et al. Temporary bacteremia due to intraoperative blood salvage during cardiovascular surgery [J]. Am J Surg, 2004, 188(3): 237-239.
[8]
Waters JH,Tuohy MJ,Hobson DF, et al. Bacterial reduction by cell salvage washing and leukocyte depletion filtration [J]. Anesthesiology, 2003, 99(3): 652-655.
[9]
Allam J,Cox M,Yentis SM. Cell salvage in obstetrics [J]. Int J Obstet Anesth, 2008, 17(1): 37-45.
[10]
Teare KM,Sullivan IJ,Ralph CJ. Is cell salvaged vaginal blood loss suitable for re-infusion? [J]. Int J Obstet Anesth, 2015, 24(2): 103-110.
[11]
Ralph CJ,Sullivan I,Faulds J. Intraoperative cell salvaged blood as part of a blood conservation strategy in Caesarean section: is fetal red cell contamination important? [J]. Br J Anaesth, 2011, 107(3): 404-408.
[12]
Cyr M,Eastlund T,Blais C Jr, et al. Bradykinin metabolism and hypotensive transfusion reactions [J]. Transfusion, 2001, 41(1): 136-150.
[13]
Choi ES,Ahn WS,Lee JM, et al. A laboratory study of the effects of processing blood through a cell salvage device and leucocyte depletion filter on levels of pro-inflammatory cytokines and bradykinin [J]. Anaesthesia, 2013, 68(12): 1259-1265.
[14]
Hussain S,Clyburn P. Cell salvage-induced hypotension and London buses [J]. Anaesthesia, 2010, 65(7): 661-663.
[15]
Rogers WK,Wernimont SA,Kumar GC, et al. Acute hypotension associated with intraoperative cell salvage using a leukocyte depletion filter during management of obstetric hemorrhage due to amniotic fluid embolism [J]. Anesth Analg, 2013, 117(2): 449-452.
[16]
徐涛,王庚,杨庆国. 白细胞滤器对术中自体血回输后促炎-抗炎细胞因子的影响[J]. 重庆医学,2011,40(12):1209-1211.
[17]
张子银. 川芎嗪对自体血回输患者围术期免疫功能的影响[D]. 广州:广州中医药大学,2011.
[18]
杨谦梓,熊利泽.产科手术回收式自体输血安全性的考量[J].中华麻醉学杂志,2016,36(11):1295-1296.
[19]
Jennings A,Brennan C. Cell salvage for obstetric patients who decline blood transfusion: a national survey [J]. Transfus Med, 2013, 23(1): 64-65.
[20]
Catling SJ,Williams S,Fielding AM. Cell salvage in obstetrics: an evaluation of the ability of cell salvage combined with leucocyte depletion filtration to remove amniotic fluid from operative blood loss at caesarean section [J]. Int J Obstet Anesth, 1999, 8(2): 79-84.
[21]
Ashworth A,Klein AA. Cell salvage as part of a blood conservation strategy in anaesthesia [J]. Br J Anaesth, 2010, 105(4): 401-416.
[22]
Goucher H,Wong CA,Patel SK, et al. Cell salvage in obstetrics [J]. Anesth Analg, 2015, 121(2): 465-468.
[23]
Royal College of Obstetricians and Gynaecologists. RCOG Green-top Guideline No. 47. Blood transfusion in obstetrics[EB/OL].(2015-05-29) [2018-04-04].

URL    
[24]
李海冰,方昕,刘志强. 术中自体血回输用于Rh(D)阴性患者剖宫产术一例 [J]. 上海医学,2015,32(12):511-513.
[25]
Brearton C,Bhalla A,Mallaiah S, et al. The economic beneifits of cell salvage in the obstetric haemorrge [J]. Int J Obstet Anesth, 2012, 21(5): 329-333.
[26]
Waters JR,Meier HH,Waters JH. An economic analysis of costs associated with development of a cell salvage program [J]. Anesth Analg, 2007, 104(4): 869-875.
[1] 李昌金, 顾昊煜, 白辰光, 胡薇. 以腋窝肿块为主要表现的免疫球蛋白G4相关疾病三例[J]. 中华乳腺病杂志(电子版), 2023, 17(04): 254-257.
[2] 罗丹, 孔为民, 陈姝宁, 赵小玲, 谢云凯. 子宫内膜异位症患者在位及异位内膜上皮细胞-间充质转化相关生物标志物的变化[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 530-539.
[3] 刘星辰, 刘娟, 魏宝宝, 刘洁, 刘辉. XIAP与XAF1异常表达与卵巢癌的相关性分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 419-427.
[4] 杨一君, 董雯, 刘晓平, 石灿, 张磊, 谷琎, 龚咪, 华馥. 腹腔镜折叠对接缝合联合宫腔镜憩室开渠法治疗剖宫产瘢痕憩室的疗效[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(03): 330-337.
[5] 董双, 李晓莹, 孙立涛, 田家玮. 影像学技术在宫颈癌术前临床分期中的应用进展[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(01): 113-119.
[6] 邹佳桐, 王颂扬, 徐薇, 余婷婷, 叶红霞, 谯小勇. 自然流产女性精神健康问题的相关危险因素分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(01): 77-84.
[7] 戴佑任, 张悦, 李扬, 王聪, 陈婷, 程文俊, 罗成燕. 未分化/去分化子宫内膜癌的临床病理学特征及治疗研究[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(06): 660-668.
[8] 陈晶晶, 钱芳. 新疆地区不同民族育龄妇女胚胎停育与叶酸代谢酶基因多态性及染色体异常的相关性[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(05): 599-605.
[9] 孙环蕊, 张若鹏. 复发性流产与肠道微生物群失衡[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(05): 506-511.
[10] 许瑛杰, 王亚琳, 宋福英, 马丽娟, 黄小兰, 苏改秀, 康闽, 侯俊, 赖建铭. 儿童系统性红斑狼疮患儿甲状腺相关抗体检测的临床意义[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(03): 282-289.
[11] 张苗苗, 付倩倩, 赵雅玫, 余小平, 周军利. 慢性创面伴自身免疫性疾病的研究进展[J]. 中华损伤与修复杂志(电子版), 2022, 17(05): 445-449.
[12] 王丁然, 迟洪滨. 自身免疫甲状腺炎对子宫内膜异位症患者胚胎移植结局的影响[J]. 中华临床医师杂志(电子版), 2023, 17(06): 682-688.
[13] 赵洁, 王岚, 杨红枚, 何屹, 袁红. 异基因造血干细胞移植后并发自身免疫性溶血性贫血患者产生类抗体血清学检测方法及输血策略[J]. 中华临床医师杂志(电子版), 2022, 16(05): 452-456.
[14] 段红霞, 刘欣, 栗方芝, 张云起, 李瑞基, 庄金强. 羊水栓塞的诊断及治疗策略研究进展[J]. 中华诊断学电子杂志, 2023, 11(02): 133-135.
[15] 陈升鑫, 翟亚奇, 卜保国, 陈德鑫, 吴浪, 方开萱, 刘文静, 李明阳, 令狐恩强. 自身免疫性胰腺炎临床特征分析[J]. 中华胃肠内镜电子杂志, 2023, 10(01): 46-51.
阅读次数
全文


摘要