中国输血杂志2025，Vol.38Issue(5)：691-698,8.DOI:10.13303/j.cjbt.issn.1004-549x.2025.05.015
孕产妇住院期间不同红细胞输注量的血液保护措施应用及对产后结局的影响
Application of blood conservation measures with different red blood cell transfusion volumes in obstetrics and their impact on postpartum outcomes
摘要
Abstract
Objective To evaluate the application of blood conservation measures in obstetric patients with different red blood cell transfusion volumes and to assess the impact of different transfusion volumes on postpartum outcomes.Methods A retrospective investigation was conducted on 448 obstetric patients who received blood transfusions at the Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine from January 2016 to December 2022.Patients were divided in-to four groups(1-2 units group,3-4 units group,5-6 units group,and>6 units group)based on the volumes of red blood cells(RBCs)transfused during and within 7 days after delivery.The maternal physiological indicators,pre-and postpartum laboratory test indicators,obstetric complications,application of blood conservation measures,use of blood products,and postpartum outcomes were reviewed.The clinical characteristics,application of blood conservation measures,and their im-pact on postpartum outcomes were compared among different transfusion groups.Results There were statistically significant differences in the multivariate logistic analysis of history of previous cesarean section(OR=1.781),eclampsia/pre-eclamp-sia/(OR=1.972)and postpartum blood loss>1 000 mL(OR=1.699)(P<0.05)among different transfusion groups.In terms of blood conservation measures,the more RBCs transfused,the higher the rate of mothers receiving blood conservation measures such as balloon occlusion,arterial ligation,autologous blood transfusion with a cell saver,and hysterectomy.With the increase in the volume of RBCs transfusion,the demand for fresh frozen plasma(FFP),cryoprecipitate,and platelet transfusions also increased.The hospitalization days for the four groups of parturients were 6.0(4.0-9.0),7.5(5.0-14.8),7.0(4.5-13.0)and 11.0(9.0-20.5),respectively(P<0.05)and the rates of ICU transfer were 2.0%(5/250),9.4%(12/128),18.2%(6/33)and 51.4%(19/37),respectively(P<0.05).Both increased significantly with the in-crease in the volume of RBCs transfusion,and the differences between groups were statistically significant.Conclusion Parturients who received higher volume of RBCs had multiple risks factors for bleeding before childbirth,had higher postpar-tum blood loss,and had a higher rate of application of various blood conservation measures.In addition,an increase in the volume of RBCs transfusion may have adverse effects on postpartum recovery.关键词
产科/红细胞输注/输血量/血液保护措施/产后结局Key words
obstetric/red blood cell transfusion/transfusion volume/blood conservation strategies/postpartum out-comes分类
医药卫生引用本文复制引用
邓慧敏,陆元善,陈绍恒,徐凤程,李梅婷,胡岚,王肖,王士玉,袁晓菲,郑俊,董泽华..孕产妇住院期间不同红细胞输注量的血液保护措施应用及对产后结局的影响[J].中国输血杂志,2025,38(5):691-698,8.基金项目
中国输血协会威高科研基金资助项目(CSBT-WG-2024-08) （CSBT-WG-2024-08）
松江区科技攻关(医药卫生领域)项目(2023SJKWGG011) （医药卫生领域）
