赴海地执行紧急医疗救护任务的血液保障

目的总结中国赴海地医疗防疫救护队的血液保障经验,增强应急状态下的血液保障能力。方法血液保障采取以人员储备为主、实物储备为辅的模式。携行的20 UO型悬浮红细胞装在自行研制的运血箱中,以相变保温材料为冷媒。采用飞机运输,在运输途中每4 h观察一次血液温度。抵达海地后采用磁珠法快速分离血浆观察质量,并通过胶体金法快速检测血浆游离血红蛋白含量。撤回的血液在4℃继续储存,至d 35有效期时采用电镜观察红细胞形态。结果救护队从南京出发至海地太子港全程共计约90 h,从太子港营地返回至南京全程共计约62 h。尽管运输途中环境温度变化较大,但运血箱内血液温度始终处于1～10℃。磁珠法快速分离血浆及胶体金法检测显示运至海地的红细胞溶血指标没有超过标准。电镜检查显示,撤回的红细胞在继续储存至d 35时异常形态者增加,但与正常对照组相比并无明显区别。结论利用自行研制的运血箱和相变保温材料,悬浮红细胞经长时间运输后,温度和溶血指标均正常,圆满完成血液保障任务。

Emergency blood transfusion services in Haiti medical rescue mission

Objective To summarize the experiences of emergency blood transfusion services carried out by Chinese Medical Antiepidemic Rescue Team in Haiti,and to enhance the ability of blood supply in emergency conditions.Methods The blood transfusion service mainly relies on personnel reserves supplemented by real blood products.A total of 20 units of type-O RBCs were put into a specialized transport container which was developed by our hospital.The independently developed phase change material served as cold source.The RBCs were transported mainly by aircraft.The temperature in the container was recorded every 4 hours during transportation.The plasma was isolated by immunomagnetic bead assay to monitor the blood quality when we reached Haiti.Plasma free hemoglobin levels were determined by colloidal gold assay.Electron microscope technique was used to evaluate the morphological changes of RBCs withdrawn from Haiti.Results The transport time from Nanjing to Haiti was nearly 90 hours and from Haiti to Nanjing 62 hours.The temperature was kept between 1 to 10℃ during transportation.The hemolysis detected by immunomagnetic bead and colloidal gold assays showed that the quality of RBCs met the criteria.Electron microscopy showed that the morphology of withdrawn RBCs after 35 d storage at 4℃ was apparently abnormal,but was not significantly different when compared to control group.Conclusion The temperature and hemolysis indices of RBCs were normal after long-time transportation from Nanjing to Haiti by independently developed transport container and phase change material.