贮存式自身输血在血液病化疗患者中的临床应用

目的:探讨贮存式自身输血在血液病化疗患者中应用。方法:对2013-01-2014-05接受贮存式自身输血的77例血液病化疗患者,在行化疗术前3d采集自身血液200~400ml,分别观察采血后、化疗时及回输后2d的主要血液指标血红蛋白(Hb)、白细胞(WBC)、血小板(PLT)变化是否具有统计学意义,同时观察并记录患者采血与回输过程是否有不良反应。结果:2例患者在采血过程中有轻度献血不良反应,3例患者因其他原因未能回输而报废,其他血液均顺利回输,回输过程无不良反应发生;与采血前相比化疗后患者主要血液指标下降明显(P<0.05)、与化疗后相比自身血液回输后Hb值有明显变化(P<0.05),而WBC、PLT值变化差异无统计学意义。结论:血液病患者化疗前采集适量血液进行贮存并在化疗结束时回输是相对安全的。对缓解血源紧张,节约宝贵的血液资源,提高输血安全性,缓解患者化疗后引起的贫血等是切实可行的有效方法,具有一定临床应用价值。     

要以科学的态度开展成分血的临床应用

随着临床医学、生物化学、免疫学、细胞生物学等学科的深入发展，使输血学也有了突飞猛进的发展。特别是成分输血，具有针对性强、疗效显著、不良反应少且综合利用节约血源等优点。然而，部分临床医师对输血的认识滞后于输血医学的发展，往往以输全血来满足患者某一种血液成分的需求，致使临床不良反应和血液资源的浪费。为提高广大临床医师的认识，促进成分血的临床应用，本文将成分输血的有关内容作一简述，以便于同仁交流。     

自体输血的临床研究进展

临床输血包括自体输血和异体输血两大类,人们日常所讲的临床输血通常是指异体输血。随着社会和医学领域对异体输血存在潜在的疾病传播的巨大风险的认识不断深入,以及血液资源严重短缺的局面又非常难以解决,自体输血的作用和意义凸显重要。自体输血是指采集受血者自身血液,或回收手术野或创伤区无污染的血液再进行回输,     

现代临床输血质量管理的探讨

我国输血医学近几年发展很快，但与发达国家相比在观念上仍然存在相当大的差距。如果不迅速更新这些观念，树立合理用血的新观念，就不可能做到科学用血和合理用血。自从1900年发现ABO血型，1916年创立血液抗凝保存液以来，经过百余年的发展输血医学已经成为了一门独立的学科。特别是近十余年来，各种高新技术不断向输血领域渗透，围绕将献血者血液输给患者进行救治这一中心，进行血液离体后的应用、研究，取得了重大成就，对保证临床输血的安全性和治疗效果提供了技术保障。     

临床输血与检验教学工作体会

输血，作为救治患者不可替代的辅助治疗手段应用于临床各科至今已有百余年的历史，医学科学的迅猛发展，使输血医学也发生着日新月异的变化，从而使它成为一门独立的临床医学学科——输血学。与此同时，日益严峻的血液安全现状，引起了国内外对安全输血问题前所未有的关注。发达国家早已将全面的输血医学教育纳入了常规的医学教育体系，但我国的输血医学教育起步较晚，随着医学科学技术和医学教育事业的发展，如何培养临床输血技术专业人才来参与指导临床输血，使临床医师科学、合理的使用血液及成分制品，达到安全、有效的治疗目的，也引起了各级政府和高校医学专业教育的重视。通过几年来讲授《临床输血与检验》这门课程及学生实习时的情况谈一谈自己的体会和建议。     

临床输血质量管理的探索

我国输血医学近几年发展很快，但与发达国家相比仍然存在相当大的差距。目前，在我国临床输血方面还存在着一些陈旧的输血观念。如果不迅速更新这些观念，树立合理用血的新观念，就不可能做到科学用血和合理用血。自从1900年发现ABO血型，1916年创立血液抗凝保存液以来，输血医学发展很快，特别是近10余年来，由于各种高新技术不断向输血领域渗透，     

自体血液回输在心脏瓣膜替换手术中的应用

目的 探讨术中血液回输技术的安全性和效果,评价其在心脏瓣膜替换手术中的应用价值.方法 本研究共选人单个心脏瓣膜替换手术32例,随机分为2组.所有患者均于全身麻醉和体外循环下行心脏瓣膜替换手术.对两组患者术中出血量.术中自体血液回输量,异体血输入量,手术前、输血前、输血后血常规和动脉血气分析结果进行观测,记录输血并发症的情况.结果 两组术中出血量差异无统计学意义;两组患者术前、输血前、术后血红蛋白（HGB）、红细胞比积（HCT）比较,差异均无统计学意义;两组血气分析的pH值、血钾、乳酸比较差异无统计学意义（P〉0.05）;而两组库血输入量差异有统计学意义（P〈0.01）.两组均未观察到有输血并发症发生.结论 在体外循环下心脏瓣膜置换术中自体血液回输可有效地减少围术期自体血的丢失,补充血容量,维持有效循环,同时明显减少异体血的用量及并发症发生,是安全、有效的,有很高的临床应用价值.     

我国成分输血的回顾与展望

我国的成分输血起步较晚,主要是在80年代发展起来的。1989年据中国输血协会的不完全统计,成分输血平均占输用全血的18%。成分输血的开展,有利于缓解血源供应的紧张状态,提高了血液的合理、有效和安全使用,扩大了输血疗法的范围,有助于临     

2016中国输血协会临床输血委员会学术年会会议通知

正为促进我国临床输血事业健康有序发展,进一步规范医疗机构的临床用血,加快输血医学领域中新观念、新技术的推广应用,加强围手术期血液保护与患者血液管理,大力推广自体输血,有效利用宝贵的血液资源,缓解血液供应紧张局面,促进临床科学合理、安全输血,不断提高临床输血水平,更好地全面促进我国临床输血学科的建设和发展。由中国输血协会临床输血工作委员会主办的国家级继续教育项目2016中国     

国际隐匿性乙型肝炎病毒感染(OBI)暨血液安全研讨会会议通知

<正>为促进我国输血医学的发展,由南方医科大学和广州血液中心共同承办的"国际隐匿性乙型肝炎病毒感染(OBI)暨血液安全研讨会"将于2014年10月9日~12日在广州南方医科大学召开,此次会议是亚太地区首次举办关于隐匿性乙型肝炎病毒感染(OBI)专题的国际性学术交流会议,同时开设中国区血液安全会议专场,届时将邀请国际输血医学领域知名专家、教授作主题报告。     

Acceptability of blood and blood substitutes

Alternatives to donor blood have been developed in part to meet increasing demand. However, new biotechnologies are often associated with increased perceptions of risk and low acceptance. This paper reviews developments of alternatives and presents data, from a field-based experiment in the UK and Holland, on the risks and acceptance of donor blood and alternatives (chemical, genetically modified and bovine). UK groups perceived all substitutes as riskier than the Dutch. There is a negative association between perceived risk and acceptability. Solutions to increasing acceptance are discussed in terms of implicit attitudes, product naming and emotional responses.     

Blood transfusion: old blood, new blood or no blood

Vigorous blood transfusion has long been regarded as having an essential role in the management of acute gastrointestinal haemorrhage. Two new studies, one a nationwide audit of acute gastrointestinal haemorrhage in the UK and another, a complex physiological study of stored blood from the USA, offer new insights.     

Red blood cell function and blood storage

Red blood cells are ideal vehicles for delivering oxygen to tissues, but their functions deteriorate during liquid preservation. In this article, we review the role of red blood cells in oxygen delivery and methods to evaluate the effectiveness of red blood cell transfusion. Quantitative estimation of transfusion effects could avoid unnecessary transfusion and reduce the risk of transfusion-associated disorders. We also describe the benefits of transfusion of red blood cells having a higher oxygen-delivering capacity. Phosphoenolpyruvate is a promising component to prepare red blood cells having a higher oxygen-delivering capacity.     

外周血白细胞计数与血压水平的关系

目的:探讨外周血白细胞计数与血压水平的关系.方法:采用横断面研究方法,从门诊及体检人群中随机抽查1136例为研究对象.根据血压水平按JNC-7标准将其分为3组:正常血压组497例(≤120/80 mmHg)、高血压前期组258例(130～139/85～89 mmHg)、高血压组371例(≥140/90 mmHg).通过...     

Rheological properties and function of blood cells in stored bank blood and salvaged blood

The technique involving filtration of diluted blood enables the separate analysis of the flow properties of different cell subpopulations. This study was designed to assess the changes occurring in the flow properties and function of blood cells in stored bank blood and salvaged blood compared to patient blood in a given clinical situation. We measured hydrogen peroxide production by neutrophils and the filterability, through 5 μm Nucleopore filters, of isolated red blood cells and of diluted blood. Samples were obtained from patients undergoing aortic surgery and blood intended for transfusion: either salvaged during surgery or stored bank blood. Both salvaged and bank blood were much less filterable than patient blood, with reduced deformability of both red and white blood cells. However, salvaged blood contained highly activated neutrophils with a prolonged transit time of the 'fast-flowing' cells in the analysis compared to bank blood. Bank blood contained significantly more particles which acted as pore-blockers. Cells in bank and salvaged blood therefore have markedly abnormal flow and biochemical properties compared to patient blood.     

Neonatal platelets from cord blood and peripheral blood

The haemostatic system in neonates is different from that of adults, possibly contributing to an increased incidence of bleeding disorders, such as intracranial hemorrhage. In this study, we analyzed platelets from cord blood and peripheral blood, collected at three time points after delivery from 20 term and 37 preterm neonates as well as blood from 20 healthy adults. Platelet membrane glycoproteins (GP) were quantified and P-selectin expression and PAC-1 binding ability before and after stimulation with TRAP were analyzed by whole blood flow cytometry. We found no significant differences in neonatal platelets from cord blood and peripheral blood within the first 24?h of life. Platelets from infants less than 30 weeks of gestation expressed lower levels of GP (33271?±?9381 vs. 44085?±?17287 for GPIIIa, P?<?0.05) and were less reactive than platelets from term newborns (4.3?±?3.3 vs. 20.1?±?11.8% PAC-1 positive platelets after stimulation with TRAP, P?<?0.05). A significantly lower level of GPIIb/IIIa expression on platelets from peripheral blood was seen in term newborns as well as preterm infants, compared to adults. There was only a partial enhancement in the degranulation ability (α-granules) (13.4?±?12.3 vs. 50.3?±?16.1% P-selectin positive platelets, P?<?0.05) and no significant increase for PAC-1 binding (13.6?±?10.9 vs. 15.3?±?5.9% PAC-1 positive platelets, P?=?0.8) during the first 12 days of life. In conclusion, we could demonstrate that neonatal platelet reactivity increases with gestational age.