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改善严重出血的胎盘积分患者的血液制品管理:机构经验
A Zabida1, G Zahavi1, J Bartoszko2
1Department of Anesthesiology, Chaim Sheba Medical Centre, Tel-Hashomer, Israel.
International journal of obstetric anesthesia
|June 26, 2023
概括
临床判断与临床检测相结合,对于在剖腹产期间管理胎盘增生谱 (PAS) 患者来说是安全的. 这种方法有效地管理了输血,最大限度地减少了这种高风险产科人群的严重并发症.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 输血医学 输血医学
背景情况:
- 胎盘增生谱 (PAS) 对产后出血有很大的风险.
- 有效的血液制品管理对于接受剖腹产 (CS) 的PAS病例的患者安全至关重要.
研究的目的:
- 描述和评估经过CS的PAS患者的血液产品管理策略.
- 确定需要改进的领域来管理这些高风险的产科患者.
主要方法:
- 对接受CS (2012-2018) 的PAS患者的术前数据的回顾性图表审查.
- 根据输血管理评估的出血严重程度,患者被分为两组.
主要成果:
- 221名PAS患者接受了CS;133人需要过度输血 (第一组),88人接受了标准治疗 (第二组).
- 没有死亡或扩散的血管内凝血; 2.2%的ICU入院.
- 第1组显示了更高的手术内血红蛋白和血小板最低值.
- 对乳酸盐,纤维素素,PAS等级和温度监测发现重大缺失的数据.
结论:
- 经验丰富的中心对PAS患者进行CS的临床判断是安全的,没有观察到显著的发病率或死亡率.
- 实施机构协议和护理点凝血检测可以减少过度输血和相关并发症.
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