Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2019, Vol. 15 ›› Issue (04): 426 -431. doi: 10.3877/cma.j.issn.1673-5250.2019.04.012

Special Issue:

Original Article

Effectiveness and safety of intraoperative cell salvage in cesarean section

Lijuan Yang1, Li Lin1, Hexin Gao1,()   

  1. 1. Department of Surgery Anesthesiology, Maternal and Child Health Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
  • Received:2019-03-14 Revised:2019-07-02 Published:2019-08-01
  • Corresponding author: Hexin Gao
  • About author:
    Corresponding author: Gao Hexin, Email:
  • Supported by:
    General Program of Natural Science Foundation of Xinjiang Uygur Autonomous Region(2019D01A18)
Objective

To investigate the effectiveness and safety of intraoperative cell salvage (IOCS) in cesarean section.

Methods

A total of 99 puerperae who underwent elective or emergency cesarean section and were treated with IOCS for intraoperative hemorrhea in Maternal and Child Health Hospital of Xinjiang Uygur Autonomous Region from January 2017 to December 2018 were enrolled into this study. The blood routine, coagulation and hemodynamics parameters of 99 puerperae before and after IOCS treatment were compared by pairwise t test, such as hemoglobin (Hb) level, diastolic blood pressure, systolic blood pressure and heart rate and so on. The volumes of intraoperative blood loss and autologous blood transfusion, urine volume and adverse reactions of IOCS were analyzed. This study was in line with the requirements of World Medical Association Declaration of Helsinki revised in 2013. Chinical research informed consents were obtained from all the subjects and their family members.

Results

①The volume of intraoperative blood loss of 99 puerperae was (882.2±55.8) mL, the autologous blood transfusion volume was (605.5±30.7) mL, the autologous blood transfusion rate was 100.0% (99/99), and the intraoperative urine volume was (400.5±20.5) mL. ②The Hb level of 99 puerperae after the treatment of IOCS was (10.2±1.4) g/L, which was significantly higher than that of (9.5±1.2) g/L before treatment; diastolic and systolic blood pressure after the treatment of IOCS were (75.2±8.1) mmHg (1 mmHg=0.133 kPa) and (120.2±3.5) mmHg, respectively, which were significantly higher than those of (45.5±8.2) mmHg and (90.0±3.0) mmHg before treatment; the heart rate was (82.6±5.2) times/min after the treatment of IOCS, which was significantly lower than that of (110.0±10.5) times/min before treatment, and all the differences above before and after the treatment of IOCS were statistically significant (t=16.595, 16.887, 3.818, 12.855; all P<0.001). ③ Among the 99 puerperae treated by IOCS, none had adverse reactions of blood transfusion, such as fever, rash, pulmonary edema, disseminated intravascular coagulation (DIC), bacteremia, etc..

Conclusions

IOCS is a safe and effective method in the treatment of puerperae with intraoperative hemorrhea during cesarean section. It has no obvious influences on coagulation functions and no serious adverse reactions of blood transfusion. However, since this study is only a retrospective study, whether IOCS technology is worthy of clinical application in the treatment of intraoperative hemorrhea during cesarean section still needs to be confirmed by the results of large sample, multi-center, randomized controlled studies.

表1 本组99例产妇采取术中回收式自体输血治疗前、后血常规、凝血功能指标及体温比较(±s)
表2 本组99例产妇采取术中回收式自体输血治疗前、后血流动力学指标比较(±s)
[1]
李剑,陈翔,吴艳琴.术中自体血回输在产科中的应用[J].浙江医学,2016,38(15): 1302-1304.
[2]
段霞,陈代娟,徐金凤,等. 凶险性前置胎盘高危孕产妇剖宫产术中回收式自体输血技术应用[J/CD]. 中华妇幼临床医学杂志(电子版),2019,15(1): 25-30.
[3]
Elagamy A, Abdelaziz A, Ellaithy M. The use of cell salvage in women undergoing cesarean hysterectomy for abnormal placentation [J]. Int J Obstet Anesth, 2013, 22(4): 289-293.
[4]
谢幸,孔北华,段涛. 妇产科学[M]. 9版. 北京:人民卫生出版社,2018: 171.
[5]
徐铭军,刘野.术中回收式自体输血在产科中的应用进展与评价[J].中国医刊,2018,53(12): 1301-1304.
[6]
Lucas DN, Bamber JH. UK Confidential Enquiry into Maternal Deaths - still learning to save mothers′ lives [J]. Anaesthesia, 2018, 73(4): 416-420.
[7]
周春波,严海雅,余萍.Rh(D)阴性血型剖宫产术产妇输血方案探讨[J].中国输血杂志,2012,25(3): 248-251.
[8]
吴云,严海雅.回收式自体输血用于剖宫产大出血救治[J].中国输血杂志,2017,30(10): 1168-1171.
[9]
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.
[10]
林毅,张仕铜,严海雅,等.凶险性前置胎盘行剖宫产时两种自体血回输应用比较[J].实用妇产科杂志,2016,32(1):38-41
[11]
Morikawa M, Kuramoto A, Nakayama M, et al. Intraopera-ive red cell salvage during obstetric surgery in 50 Japanese women[J]. Int J Gynaecol Obstet, 2015, 128(3): 256-259.
[12]
Sparić, R, Lazović, B, Sulović, N, et al. Our experience with intraoperative cell salvage during cesarean delivery in women with uterine myomas: four case reports[J]. Med Pregl, 2014, 67(3-4): 111-117.
[13]
Milne ME, Yazer MH, Waters JH. Red blood cell salvage during obstetric hemorrhage[J]. Obstet Gynecol, 2015, 125(4): 919-923.
[14]
Dhariwal SK, Khan KS, Allard S, et al. Does current evidence support the use of intraoperative cell salvage in reducing the need for blood transfusion in caesarean section? [J]. Curr Opin Obstet Gynecol, 2014, 26(6): 425-430.
[15]
Chung HS, Cho SJ, Park CS. Effects of liver function on ionized hypocalcaemia following rapid blood transfusion [J]. J Int Med Res, 2012, 40(2): 572-582.
[16]
Liumbruno GM, Liumbruno C, Rafanelli D. Autologous blood in obstetrics: where are we going now? [J]. Blood Transfus, 2012, 10(2): 125-147.
[17]
谭华,陈新忠. 产科回收式自体输血新进展[J].现代实用医学,2016,28(2): 141-144.
[18]
曾雅静,叶惠芬,吴远军,等.回收式自体输血对产科手术患者血液流变学和凝血功能的影响[J].中国输血杂志,2016,29(2): 159-161.
[19]
余超,顾娟,罗东.白细胞滤器联合血液回收机用于产科自体血回收的研究进展[J].中国输血杂志,2017,30(8): 965-968.
[20]
桑本玲,季伟俐,杨悦,等.术中自体血回收用于产科手术的可行性研究[J]. 中国输血杂志,2016,29(7): 719-721.
[21]
李海冰,刘志强.术中自体血回液回输在产科中应用的研究进展[J/CD].中华妇幼临床医学杂志(电子版),2018,10(14): 617-620.
[22]
黄桂华,周明强. 大量自体血回输对患者pH值、电解质及凝血功能的影响[J]. 中国医师进修杂志,2013,36(24):36-37.
[23]
Suzuki Y, Okai K, Ohashi H, et al. Autologous blood transfusion for hemodialysis patients: a case report and review of clinical reports and therapeutic features [J]. Transfus Apher Sci, 2015, 52(2): 204-207.
[24]
危先江,方小勤,童玲. 不同液体复苏方法对产科失血性休克患者脏器功能和炎症介质的影响[J]. 中国医师杂志,2017,19(5):737-739.
[25]
Horstmann WG, Swierstra MJ, Ohanis D, et al. Favourable results of a new intraoperative and postoperative filtered autologous blood re-transfusion system in total hip arthroplasty: a randomised controlled trial[J]. Int Orthop, 2014, 38(1): 13-18.
[26]
卫新,邢娜,张卫.英国产科术中自体血回收的发展历程[J].临床麻醉学杂志,2015,31(6):614-616.
[27]
Qureshi H, Massey E, Kirwan D, et al. BCSH guideline for the use of anti-D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn [J]. Transfus Med, 2014, 24(1):8-20.
[28]
聂志扬,胡俊华,宫济武.英国皇家妇产科医师学院《产科输血指南》(第2版)解读[J].中华围产医学杂志,2016,19(8):565-567.
[29]
王瑞含,刘久波. 回收式自体输血在剖宫产术中的应用现状[J]. 临床输血与检验,2019, 21(1):112-115.
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