Избирательный подход к коррекции нарушений гемостаза при массивных акушерских кровопотерях гемокомпонентами с учетом качества гемостаза доноров крови

Abstract

Aim: to improve the treatment of puerperants with massive blood loss by individual selection of blood products according to parameters of donor’s hemostasis and coagulopathy character in puerperants. Materials and methods. The study included 2 stages. At the first stage, hemostatic parameters in various categories of donors were studied depending on age and other factors. The number of erythrocytes,hemoglobin content, Lee-White bloodclot- ting time (BCT), activated partial thromboplastin time (APTT), platelet aggregation, fibrinogen content, antithrombin III (AT-III) and total serum protein were determined in 200 donors (100 men and 100 women) aged from 18 to 65 years. At the second stage, 67 puerperants with massive blood loss were examined. The main group (MG) included 37 (55.2%) puerperants; they received individual transfusion therapy that takes into account hemostatic parameters of puerperant and donor. The control group (CG) consisted of 30 (44.8%) puerperants; they received standard transfusion therapy without individual selection of donated plasma. Erythrocyte counts, hemoglobin content, Lee-White BCT, APTT, prothrombin time, international normalized ratio, platelet aggregation, fibrinogen concentration and AT-III were studied in patients. Results. Three types of fresh frozen plasma (FFP) were obtained from donated blood: FFP with normal content of blood clot- ting factors; FFP with high content of blood clotting factors; FFP with normal content of blood clotting factors and high con- tent of anticoagulative factors. Irrespectively of the causes of massive blood loss, the necessity in FFP for puerperants from MG (with individual selection of transfusion media) was less than for puerperants from CG (p < 0.05). Conclusion. 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