2012-2017新疆生产建设兵团八家血站采供血情况分析

目的:了解新疆生产建设兵团八家采供血机构近6年来无偿献血情况和临床供血情况,为兵团采供血工作、输血工作的发展及进一步制定无偿献血者招募策略、督促临床科学合理用血提供数据参考。方法:选取新疆生产建设兵团八家采供血机构2012年-2017年采供血数据,比较每年的采血情况、供血情况。结果:2012-2017年献血人次呈负增长,2017年千人口献血率10.07‰,供应临床各类血液总量呈负增长,成分输血率达到99.5%。结论:加强无偿献血宣传和健康教育促进,扩大宣传范围和方式,促使更多适龄人群加入无偿献血者队伍。加强临床科学、合理用血,作到开源节流。     

7666名互助献血者对无偿献血知识认知及献血心理调查简

目的：调查分析7666名亲友互助献血者的认知态度及心理因素。方法对本中心参加互助献血的7666名亲友献血者进行调查问卷,调查内容包括献血者的性别、年龄、职业等一般资料,以及献血者对互助献血的认知态度及心理调查。结果7666名被调查者中,男性多于女性、青年人多于青壮年及中年人、军人多于其它职业者、初次献血者多于重复献血者（P＜0.01）;在献血知识认知中,了解和赞成互助献血的显著少于不了解和不赞成互助献血者（P＜0.01）、而本人信任和家人支持互助献血的却显著多于不信任和不支持（P＜0.01）;在献血心理调查中,献血动机“亲情友情”和“奉献爱心”显著多于其它选项（P＜0.01）、献血心理障碍“疼痛”与“恐惧感”显著多于其它选项（P＜0.01）、献血纪念品“公益物品”和“定制纪念品”显著多于其它选项、献血心理需求“献血或用血凭证”显著多于其它选项。结论开展亲友互助献血能有效缓解临床用血供需矛盾,更进一步加强无偿献血知识宣传;通过亲友互助献血,动员招募更多的献血员、扩大低危人群志愿无偿献血者队伍,形成无偿献血的长效机制。     

用KAP研究结果分析当前无偿献血工作存在的问题

目的:希望找出影响人们献血的因素。方法:KAP研究釆用问卷方法了解大众对于献血的知识、态度和行为的认识程度。结果:献血者中的自我否定现象导致了准献血员的大量流失。结论:开展健康教育不足,宣传不到位。2003年5月至2004年5月,新疆乌鲁木齐兵团血站,乌鲁木齐市血液中心的工作人员和美国约翰·霍普金斯大学公共卫生系合作,进行一项研究,调查新疆地区不同人群对于献血的了解和理念。中国在血液供应上有很大的问题,并且在招募志愿献血者上也存在一些问题。     

乌鲁木齐市无偿献血人群分布及献血动机调查分析

目的探讨乌鲁木齐市无偿献血者的人群分布及献血动机,为今后的无偿献血工作提供实践依据和宣传策略。方法采用问卷调查法,对乌鲁木齐市2 000名无偿献血者进行问卷调查,将调查结果进行统计学分析。结果学生、服务人员、私营业主、城镇户籍及常住本市的外来人口是乌鲁木齐市无偿献血的主力军;"奉献爱心"是公民献血的主要原因(87.2%),不同文化程度、不同职业的无偿献血人群献血动机有明显差异(χ2文化程度=59.780,P<0.05;χ2职业=102.339,P<0.05);"街头宣传"、"周围环境影响"、"大众媒体宣传"是献血人群了解献血知识的主要渠道。结论加强不同形式的宣传力度,挖掘不同人群的血源潜力,建立一支固定的无偿献血队伍。     

血站质量管理工作中应用差错管理的效果探讨

目的 探讨血站质量管理工作中应用差错管理对其不良事件发生情况和满意度的影响。方法 选取2021年1月～2021年6月收集的健康血液标本4 896例,采供血工作人员54例,献血者108例,用血医院15例作为对照组,2021年7月～2021年12月收集的健康血液标本4 896例,采供血工作人员54例,献血者108例,用血医院15例作为观察组。对照组给予常规管理方法,观察组给予差错管理方法。比较两组管理后的温湿度控制、设备维护保养、消毒效果评分、献血反应、献血者的满意度、用血医院的满意度、健康教育覆盖率、理论知识、操作技能考核成绩及质量管理水平,管理期间的差错事件及不良反应事件的发生情况。结果 管理后观察组温湿度控制、设备维护保养、消毒效果评分、理论知识、操作技能考核成绩及质量管理评分均高于对照组;管理期间观察组差错事件总发生率为0.71%,低于对照组的1.88%;管理后观察组献血反应发生率为1.85%,低于对照组的11.11%;观察组的献血者的满意度、用血医院的满意度、健康教育覆盖率分别为98.15%、100.00%、100.00%,高于对照组的89.81%、73.33%、90.74%;管...     

献血所致应激状况及其影响因素的调查研究

目的调查献血者在献血前的应激程度,了解其应激状况及主要影响因素。方法在天津市2个献血点的献血者中随机抽取51名献血者,并同时选取55名未献血者作为对照组,采用国际通用的应激状况调查问卷（The Stress Test）对上述人群进行调查,采用SPSS软件进行统计学处理。结果本次调查获有效问卷106份,经分析显示,献血者应激水平明显高于非献血者。性别、年龄、受教育程度以及既往献血史均对献血者的应激水平具有重要影响。结论性别、年龄、受教育程度以及既往献血史均是影响献血者应激水平的重要因素。     

全军积极开展2011年“世界献血者日”活动

2011年6月14日是第8个“世界献血者日”,主题是“捐献更多血液,挽救更多生命”,旨在动员世界各地更多的人定期自愿无偿献血。全军和武警部队积极响应总后卫生部的号召,结合“创先争优”活动,广泛开展了形式多样的献血主题宣传活动。驻京部队组织了500余人参加的大型现场献血活动,12家驻京军队医院分别开展了献血者感谢墙活动;解放军乌鲁木齐血站与当地少数民族稀有血型捐献者开展了联谊活动;济南军区组织所属采供血机构,深入部队开展了献血宣传活动;南京军区血液中心组织了无偿献血和输血知识讲座、     

北京地区无偿献血者庚型肝炎感染情况初步调查研究

目的 分析不同献血人群中庚型肝炎病毒(HGV)的感染情况,及其对血液安全性的影响,为血液筛查策略调整提供科学依据.方法 收集694例无偿献血者血浆标本,逆转录聚合酶链法(RT-PCR)检测血浆中HGV RNA,χ2检验比较不同献血人群HGV感染情况.结果 694例献血者共检出HGV RNA阳性15例(2.16％),93例部队献血者均未检出HGV RNA,164例街头献血者中HGV RNA阳性3例(1.83％),437例血站血小板献血者中HGV RNA阳性12例(2.75％).结论 部队献血者、街头献血者和血站血小板献血者3组献血人群的HGV感染率无差异,儿童患者、造血干细胞移植后的受血者等高危受血者有必要进行HGV筛查.     

献血频次对献血者骨密度影响的观察

目的:观察献血频次对献血者骨密度的影响。方法:选择长期频繁机采捐献血小板者29例为观察组,单次机采血小板献血者24例为对照组。比较两组采血后髋关节和第2～4腰椎骨密度水平及采血前中后血清钙离子(Ca2+)水平。结果:两组骨密度水平与血清Ca2+水平差异均不显著(P>0.05)。结论:献血频次对献血者骨密度影响不显著。     

献血自评量表初步编制及在无偿献血中的应用

目的设计编制一套全面及适合国情的无偿献血行为自评量表,为献血研究提供工具。方法根据无偿献血中取得的经验及相关数据,参照文献,筛选出20个题目(含献血认知、献血前情绪、献血感知3个因子)。调查参加无偿献血的部队官兵及高校学生117例,取得各条目及因子评分等相关数据,并对首次及2次以上献血进行比较。结果发放量表120份,回收率100%,有效率97.5%。两次以上献血27例(A组),首次献血90例(B组)。两组总粗分、总均分、标准分、标准均分及Ⅱ,Ⅲ因子总粗分、总均分均有非常显著差异(P<0.01)。结论自评量表的编制可对献血者心理状况进行评估分析,并为无偿献血筛选血源及心理咨询等提供参考。     

Psychological structure of personality and motivation in blood donors]

The study comprised 500 persons who donated blood for five and more times. The psychic personality structure was studied by EMOTIONS PROFILE INDEX tests with the forced-choice personality index (4) by Henry Kellerman and Robert Plutchnik. Blood donor motivation was examined by the standardized questionnaires which was interpreted by the so-called keys of desirable responses, separately for every potentially primary motive (altruism; habits; superiority complex; inferiority complex; selfpunishment; benefit; indefinite motive). The aim of the study was to assess whether the psychic structure of a personality has effects on blood donor motivation. The study has shown that: a) the psychic personality structure in repeated blood donors has effects on their blood donor motivation; b) altruism is the most common motive for blood donation in persons with the emotionally stable structures of personality and in persons with neurotic potentials; c) among persons with different psychic personality structure there are differences in the percentage of some of primary motives for blood donation. The altruism is the most common motive for blood donation found in 85% of repeated blood donors. All other motives together are found in 8% of cases while in 7% of the examines it was not possible to confirm the primary motive for blood donation.     

CT灌注成像评估活体肝移植术后肝脏血液动力学变化

目的：探讨CT灌注成像技术在评估活体肝移植术后肝脏血液动力学变化中的临床应用价值。方法：35例右叶活体肝移植供体,30例右叶活体肝移植术后无SFSS受体及6例伴SFSS受体患者均行肝脏CT灌注成像,测量各组活体肝移植术前供体及术后14天和28天受体肝总血流量（TBF）、肝动脉灌注量（HAP）及门静脉灌注量（PVP）。分析和各组之间灌注参数的差异及相关性。结果：与正常供体捐赠前[（PVP0=（82．5±13．0）ml／（min·100g）]相比,无SFSS受体的患者在术后14天和28天时PVP明显增高[PVP14=（139．7±40）ml／（min·100g）,PVP28=（109．8±19）ml／（min·100g）],差异有极显著性意义（P〈0．001和P=0．008）,但术后28天PVP较术后14天明显降低（P=0．007）。SFSS组术后14天PVP较无SFSS组明显增高[PVP14=（186．0±22．0）ml／（min·100g）],差异有显著性意义（P=0．042）。结论：CT灌注成像能准确评价无SFSS供体血流动力学改变。     

无偿献血者梅毒抗体筛检方法与试剂的价值评价

目的：评价无偿献血者梅毒抗体筛检方法与试剂的筛检价值。方法：以卫生部临床检验中心梅毒抗体临床科研血清盘标本40份及随机抽取西安市无偿献血者梅毒抗体阴性血清100份为评价标本。用梅毒甲苯胺红不加热血清试验(TRUST)法，厦门新创梅毒抗体ELISA1诊断试剂盒(ELISA1)及北京金豪梅毒抗体ELISA诊断试剂盒(ELISA2)对评价标本作盲法筛检，以卫生部临床检验中心梅毒抗体已知阳性和阴性作为金标准。用四格表法评价真实性与可靠性指标，并对二种ELISA试剂盒的Cut-off值的合理性进行评价。结果：TRUST法、ELISA1及ELISA2试剂盒的灵敏度分别为68．2％，95．5％，100．0％，特异度分别为77．8％，94．4％，94．4％，约登指数分别为0．46，0．900．94，重复试验符合率分别为90．0％，100．0％，100．0％，二种ELISA试剂盒的Cut-off值较合理。结论：ELISA试剂盒的灵敏度、特异度及重复试验符合率要远高于TRUST法。尽管TRUST法的灵敏度与特异度较低，在无偿献血者的粗筛快检中可降低血液报废率，因而在无偿献血中的仍有很高价值，如果将ELISA试剂盒的灵敏度与特异度加以提高，将会具有更大的临床应用价值。     

Hepatic macrosteatosis: predicting appropriateness of liver donation by using MR imaging--correlation with histopathologic findings

PURPOSE: To retrospectively evaluate the diagnostic performance of magnetic resonance (MR) imaging in predicting the appropriateness of liver donation in potential living liver donors by using histopathologic results as the reference standard. MATERIALS AND METHODS: This study was approved by institutional review board; all patients gave informed consent for the use of MR data for future research. Fifty-seven potential liver donors (40 male, 17 female; age range, 17-57 years; mean age, 32 years) underwent dual-echo 1.5-T MR imaging. Two radiologists qualitatively graded each MR image, with consensus for disagreements. Livers were assigned one of three degrees of hepatic steatosis on the basis of changes in hepatic signal intensity (SI) between in-phase and opposed-phase images. For quantitative analysis, a third radiologist calculated mean hepatic and mean splenic SI by averaging 25 hepatic regions of interest and three splenic regions of interest. Relative SI decrease (RSID) in the liver on opposed-phase images compared with in-phase images was calculated. Linear regression analysis was used to correlate RSID with the degree of total steatosis, macrosteatosis, and microsteatosis. Diagnostic performance for predicting the appropriateness of liver donation was analyzed. RESULTS: Histologic findings of macrosteatosis resulted in 52 patients being categorized as appropriate donors, with the remaining five being categorized as inappropriate donors. RSID was correlated with total steatosis (r = 0.850). When the RSID criterion for inappropriateness of liver donation was set at 20%, the sensitivity, specificity, and accuracy were 100%, 92.3%, and 93%, respectively. When RSID was used, four livers that had been misclassified as inappropriate for transplantation were found to have microsteatosis of various degrees and a less than moderate degree of macrosteatosis at histologic analysis. Qualitative and quantitative analyses were comparably accurate. CONCLUSION: When an RSID criterion of less than 20% was used, dual-echo MR imaging facilitated the correct prediction of appropriateness of liver donation in 53 of 57 patients.     

Organ donation and transplantation

Medical imaging plays a key role in many aspects of organ donation, procurement and transplantation. Imaging techniques are used to confirm a diagnosis of brain death, measure organs, assess potential donors and recipients, and evaluate the success of surgery. This article offers an overview of organ donation and transplantation. After completing this article, readers will: Understand what U.S. laws apply to organ donation and which organizations play a part in the transplant process. Describe methods for determining death. Explain how organs are procured and allocated. Describe the role medical imaging plays in organ donation and transplantation. Discuss the controversies surrounding organ donation.     

Postmortale Gewebespende in der Rechtsmedizin

After confirmation of death, tissues can be explanted from the deceased for transplantation purposes within a post-mortem period of 36 h (e.g. cardiovascular, musculoskeletal tissue and skin donations) or 72 h (cornea donation) in accordance with the donors’ wishes expressed while they were alive and depending on the medical and social history. In contrast, an organ donation can only be considered in cases of brain dead patients in whom the cardiovascular function is maintained. Multiple organ donors can also donate tissue although organ donation has priority. In contrast to organ transplantation, tissue transfer does not have to conform to any compatibility requirements, i.e. every donor can donate tissue for any recipient. While organ donation is organized centrally by the“Deutsche Stiftung Organtransplantation” (DSO, German Foundation for Organ Transplantation), tissue donation is not. The“Transplantationsgesetz” (TPG, German Transplantation Act) stipulates that the donor must be reported to the nearest tissue institution; however, this is often neglected due to ignorance of existing structures or not knowing the donor’s wishes. The following text describes the legal, medical and social prerequisites, the organization and process as well as transplantation indications for post-mortem tissue donation.     

Living related liver transplantation: preoperative magnetic resonance imaging for assessment of hepatic vasculature of donor candidates

Purpose: To evaluate the accuracy of magnetic resonance angiography (MRA) for preoperative assessment of hepatic vascular anatomy in liver donors before living related liver transplantation.

Material and Methods: A total of 55 consecutive living liver donors (mean age 42 years, range 18-68 years) underwent multiphase contrast-enhanced MRA of the hepatic vessels. Two readers categorized vessel visualization on a five-point scale and recorded vascular anatomy or variations thereof for the arterial, portal venous and venous systems. All 55 living liver donors subsequently underwent right hemihepatectomy for hemiliver donation, and preoperative MRA results were correlated with surgical findings.

Results: Overall vessel visualization assessment demonstrated good or very good ratings for the majority of patients. For hepatic arteries, the mean score was 4.4±0.8 (mean±standard deviation), and for the portal venous and venous systems it was 4.6±0.7 and 4.3±0.8, respectively. Among all 55 donors, 16 (29%) demonstrated accessory or replaced hepatic arteries, and seven (13%) and 20 (36%) donors had surgically relevant portal vein (trifurcation or early right posterolateral branching types) and hepatic vein variations, respectively. Correlation coefficients between MRA and surgery were 0.94, 1.00 and 0.91 for hepatic arteries, portal veins and hepatic veins, respectively.

Conclusion: In the preoperative evaluation before living related liver donation, contrast-enhanced MR angiography was a highly accurate, noninvasive tool for visualizing the hepatic vasculature and variations thereof in liver donor candidates.     

心脏死亡者供肝移植术后受体早期肝功能恢复不良的影响因素分析

 目的 探讨“中国二类”(DCD)和“中国三类”(DBCD)心脏死亡器官捐献(统称为DCD)的供体和受体因素对肝移植术后早期肝功能恢复不良的影响。方法 回顾性分析2013-09至2017-01在解放军总医院第三医学中心实施的211例DCD肝移植的临床资料,主要包括供体和受体的性别、年龄、原发病、血型、体质量指数(BMI)、既往病史、ICU住院时间、机械通气时间、热缺血时间、冷缺血时间、术中出血量、MELD评分、术后早期肝功能及预后等指标。采用χ²检验及多因素Cox回归方法分析影响肝移植术后早期肝功能恢复及预后不良的风险因素。结果 受体术中出血量(P=0.046)、受体BMI(P=0.035)、受体MELD评分(P=0.000)、供体年龄(P=0.047)、供体性别(P=0.028)、供体血K⁺水平(P=0.001)、拔管到心脏停跳时间(P=0.001)、供体ICU住院天数(P=0.022)均与受体术后早期肝功能恢复不良有关。多因素分析显示:术中出血量(P=0.001,HR=12.512,95%CI: 2.679～58.434)、受体MELD分级(P=0.021,HR=3.991,95%CI:1.237～12.876)是独立风险因子。结论 控制术中出血量及选择MELD<25的受体将有助于改善DCD受者肝移植术后早期肝功能恢复不良及预后。