摘要
目的分析亲体子宫移植患者围术期临床用血情况,探讨子宫移植患者围术期的输血策略,评估患者输血后疗效,初步制定我院关于子宫移植患者的输血方案,保障患者用血安全。方法通过回顾性查阅临床病例资料,对我院2016年1月及2018年1月实施的2例亲体子宫移植患者术后血红蛋白急剧下降、凝血紊乱的原因及术后临床用血情况进行分析,复查输血相容性相关检查项目,红细胞均采用同型配合型输注治疗,非红血液制品均采用同型输注,观察移植前后患者血常规、凝血、血液生化等指标变化,并对子宫移植患者输血治疗有效性进行评估。结果经分析,2例子宫移植患者围术期血常规、凝血指标变化明显系多方面因素所致,术后给予同型配合型辐照、去白细胞悬浮红细胞进行支持性治疗,结合多学科的临床救治,患者最终康复出院。结论子宫移植患者围术期发生血红蛋白急剧下降、凝血紊乱的原因需考虑多方面因素,完善输血相关血清学检查的同时,应综合考虑患者的临床诊疗过程,给予正确的临床输血策略及临床治疗方案,保障患者安全。
Objective We analyzed the postoperative blood transfusion in patients undergoing uterus transplantation(UTx),and discussed transfusion strategy and evaluated the efficacy.We formulated the transfusion plan to ensure the blood transfusion safety.Methods We retrospectively reviewed the clinical data of 2 cases of patients with UTx performed in January 2016 and January 2018.We analyzed hemoglobin,coagulation disorders and clinical blood use in postoperative period.We repeated compatibility testing.Red cells were transfused with blood type compatibility and non-red cells blood products were transfused with the same blood type.We observed changes in blood routine,coagulation,blood biochemistry and other indicators of patients before and after transplantation,and evaluated the effectiveness of transfusion.Results Perioperative changes in blood routine and coagulation functions in 2 patients with UTx were obviously caused by various factors.Leukoreduced and irradiated packed red blood cells were given after surgery for supportive treatment.Combined with multidisciplinary clinical treatment,patients recovered and were discharged from hospital.Conclusion The cause that hemoglobin drop acutely in uterine transplantation patient should be taken into account in many factors.While improving blood transfusion related serological examination,the clinical diagnosis and treatment process of patients should be comprehensively considered.Transfusion strategy and clinical treatment plan should be given to ensure patient safety.
作者
王文婷
刘启旺
张嵘
党盼玉
顾顺利
胡兴斌
刘杨
尹文
WANG Wen-ting;LIU Qi-wang;ZHANG Rong(Xijing Hospital of the Air Fouth Military Medical University,Shaanxi 710032)
出处
《临床输血与检验》
CAS
2021年第5期551-555,共5页
Journal of Clinical Transfusion and Laboratory Medicine
关键词
亲体子宫移植
配合型输血
输血治疗效果
输血安全
Parental uterine transplantation
Combined transfusion
Therapeutic effect of blood transfusion
Blood transfusion safety
