不同抗凝剂自体血回输对输卵管妊娠破裂患者炎症因子的影响(1)
摘 要：目的 探讨采用不同抗凝剂进行自体血回输的临床实用性和对输卵管妊娠破裂患者的炎症因子的影响。方法 选取我院2014年1月～2015年8月收治的输卵管妊娠破裂出血患者60例，随机分为H组和C组，每组30例。H组行肝素抗凝剂，C组行枸橼酸钠抗凝剂，收集术野失血进行自体血回输，检测回输后两组患者TNF-α、IL-6、IL-8、IL-10的变化。结果 两组患者TNF-α在T3和T6时与T1相比明显升高，IL-6、IL-8在T3、T4、T5是逐渐升高，T6时回落，IL-10在T2后持续升高直至T6，存在统计学意义(P<0.01)。与H组比较，C组IL-6、IL-8和IL-10在T3、T4、T5、T6时浓度明显低于H组，存在统计学意义(P<0.01)。结论 与肝素组比较，枸橼酸钠组自体血回输后体内炎症因子释放较少， 但操作繁琐、不安全，临床实用性低于肝素组。
关键词：枸橼酸钠；肝素；自体血回输；炎症因子；
中图分类号：R714.22 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.04.019
, 百拇医药
文章编号：1006-1959(2018)04-0059-03
Abstract：Objective To investigate the clinical practicability of autologous blood transfusion with different anticoagulants and its influence on inflammatory factors in patients with rupture of tubal pregnancy.Methods 60 patients with rupture of tubal pregnancy were selected from January 2014 to August 2015 in our hospital.They were randomly divided into group H and group C，with 30 cases in each group.Group H received heparin anticoagulant，group C received sodium citrate injection for transfusion，collecting blood loss from field operation and autotransfusion，and detected the changes of TNF-，IL-6，IL-8 and IL-10 in two groups after transfusion.Results The two groups of patients TNF- alpha at T3 and T6 compared with T1 increased significantly，IL-6，IL-8 in T3，T4，T5 increased gradually，T6 decreased，IL-10 increased continuously until after the increase，until there was statistical significanc(P<0.01).Compared with the H group，the concentrations of IL-6，IL-8 and IL-10 in group C were significantly lower than those of the H group at T3，T4，T5 and T6，and there was a statistical significance(P<0.01).Conclusion Compared with heparin group，the release of inflammatory factors in the sodium citrate group after autologous blood transfusion is less，but the operation is tedious and unsafe，and the clinical practicability is lower than that of heparin group.
, 百拇医药
Key words：Sodium citrate；Heparin；Autologous blood transfusion；Inflammatory factors
輸卵管妊娠破裂是妇科常见的急腹症，起病急，变化快，如救治不及时，易发生失血性休克，甚至抢救无效死亡。目前，在血液资源紧缺的情况下，回收式自体输血(intraoperative autotransfusion，IAT)能有效减少此类患者异体血输注，减少输血的不良反应，节约血资源，防止血源性传染病的传播。但随着IAT技术在临床的广泛运用，其对患者术后炎症反应的影响不容忽视。本研究选取我院2014年1月～2015年8月收治的输卵管妊娠破裂出血需要手术的患者60例，旨在探讨不同抗凝剂自体血回输对患者炎症因子的影响，现报道如下。
1 资料与方法
1.1研究对象 选取我院2014年1月～2015年8月收治的输卵管妊娠破裂出血需要手术的患者60例，年龄21～48岁，ASA分级Ⅰ～Ⅱ级，体重44～71 kg，术前无血液系统疾病，免疫系统疾病，无急慢性感染病史，无心、肺、肝、肾功能不全，近期无输血史。患者行孕卵端切除术，术中血液未污染。纳入研究的病例回收血量>800 ml。患者随机分入肝素组(H组)和枸橼酸钠组(C组)，每组30例。将自体血回输后血红蛋白低于70 g/L需输注异体血治疗的患者排除在实验之外。, http://www.100md.com(刘娜 马庆杰 金华)
关键词：枸橼酸钠；肝素；自体血回输；炎症因子；
中图分类号：R714.22 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.04.019
, 百拇医药
文章编号：1006-1959(2018)04-0059-03
Abstract：Objective To investigate the clinical practicability of autologous blood transfusion with different anticoagulants and its influence on inflammatory factors in patients with rupture of tubal pregnancy.Methods 60 patients with rupture of tubal pregnancy were selected from January 2014 to August 2015 in our hospital.They were randomly divided into group H and group C，with 30 cases in each group.Group H received heparin anticoagulant，group C received sodium citrate injection for transfusion，collecting blood loss from field operation and autotransfusion，and detected the changes of TNF-，IL-6，IL-8 and IL-10 in two groups after transfusion.Results The two groups of patients TNF- alpha at T3 and T6 compared with T1 increased significantly，IL-6，IL-8 in T3，T4，T5 increased gradually，T6 decreased，IL-10 increased continuously until after the increase，until there was statistical significanc(P<0.01).Compared with the H group，the concentrations of IL-6，IL-8 and IL-10 in group C were significantly lower than those of the H group at T3，T4，T5 and T6，and there was a statistical significance(P<0.01).Conclusion Compared with heparin group，the release of inflammatory factors in the sodium citrate group after autologous blood transfusion is less，but the operation is tedious and unsafe，and the clinical practicability is lower than that of heparin group.
, 百拇医药
Key words：Sodium citrate；Heparin；Autologous blood transfusion；Inflammatory factors
輸卵管妊娠破裂是妇科常见的急腹症，起病急，变化快，如救治不及时，易发生失血性休克，甚至抢救无效死亡。目前，在血液资源紧缺的情况下，回收式自体输血(intraoperative autotransfusion，IAT)能有效减少此类患者异体血输注，减少输血的不良反应，节约血资源，防止血源性传染病的传播。但随着IAT技术在临床的广泛运用，其对患者术后炎症反应的影响不容忽视。本研究选取我院2014年1月～2015年8月收治的输卵管妊娠破裂出血需要手术的患者60例，旨在探讨不同抗凝剂自体血回输对患者炎症因子的影响，现报道如下。
1 资料与方法
1.1研究对象 选取我院2014年1月～2015年8月收治的输卵管妊娠破裂出血需要手术的患者60例，年龄21～48岁，ASA分级Ⅰ～Ⅱ级，体重44～71 kg，术前无血液系统疾病，免疫系统疾病，无急慢性感染病史，无心、肺、肝、肾功能不全，近期无输血史。患者行孕卵端切除术，术中血液未污染。纳入研究的病例回收血量>800 ml。患者随机分入肝素组(H组)和枸橼酸钠组(C组)，每组30例。将自体血回输后血红蛋白低于70 g/L需输注异体血治疗的患者排除在实验之外。, http://www.100md.com(刘娜 马庆杰 金华)