Influence of acute normovolemic hemodilution on routine blood indicators and cytokines in surgery patients with ectopic pregnancy
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摘要: 目的:探讨急性等容血液稀释对异位妊娠手术患者血常规及细胞因子的影响。方法:选择117例异位妊娠患者,根据自愿原则及是否符合纳入标准分为观察组54例与对照组63例,观察组行术中急性等容血液稀释,对照组行异体输血。测定2组术前、术后RBC、Hb、Hct、PLT等血常规指标及血浆白细胞介素-6(IL-6)、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)水平。结果:(1)2组在年龄、体重、术前Hb及Hct、失血量等基线资料方面无明显差异(P>0.05),观察组异血输注量明显少于对照组(P<0.05);(2)观察组术后2dRBC、Hb、Hct水平显著高于对照组(P<0.05);(3)与术前比较,2组术后1d、术后7dIL-6均显著升高(P<0.05),观察组升高幅度高于对照组(P<0.05);观察组术后7dIFN-γ显著升高(P<0.05),而对照组术后1d显著下降(P<0.05);2组手术前后TNF-α水平无显著变化(P>0.05)。结论:急性等容血液稀释用于异位妊娠手术,可有效提高红细胞利用率,明显减少患者的异体输血量,减轻输血对患者的免疫抑制作用,具有重要的临床应用价值。Abstract: Objective:To explore the influence of acute normovolemic hemodilution on routine blood indicators and cytokines in surgery patients with ectopic pregnancy.Method:A total of 117 patients with ectopic pregnancy were chosen as the research objects.All patients were divided into observation group (n=54) and control group (n=63),the patients in observation group were implemented ANH and the patients in control group were carried out allogeneic blood transfusion.The routine blood indicators as Hb,Hct,Plt and plasma levels of IL-6,IFN-γ,TNF-αwere determined.Result:① The baseline data such as age,body mass,preoperative Hb,preoperative Hct,blood loss were no statistical differences (P>0.05) in two groups,the volume of allogeneic blood transfusion in observation group were lower than that in control group (P<0.05).② The levels of RBC,Hb,Hct at postoperative 2d were higher than those in control group (P<0.05).(3) Compared with before the operation,the levels of IL-6 at postoperative 1d and 7d increased significantly (P<0.05) in two groups,higher degree in observation group was higher than that in control group(P<0.05).The levels of IFN-γat postoperative 7dincreased significantly (P<0.05) in observation group,the levels of IFN-γat postoperative 1d decreased significantly (P<0.05) in control group.The preoperative,postoperative levels of TNF-αwere no obvious change in two groups (P>0.05).Conclusion:ANH may effectively improve the utilization rate of red blood cells and significantly reduce the amount of allogeneic blood transfusion in patients with ectopic pregnancy surgery,reduce immune inhibition for the patients,and has important clinical value.
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Key words:
- ectopic pregnancy /
- aute normovolemic hemodilution /
- IL-6 /
- IFN-γ /
- TNF-α
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