自体血回输的研究进展

在临床用血日益增多的今天,血源日趋紧张,异体输血有传播肝炎、爱滋病,输错血型导致溶血等危险,血液保护已被提到日程上,自体血回输受到广泛的重视,它避免了异体输血可能带来的不良反应和传染性疾病的传播,对机体影响不大,有较大的优越性,是一种安全、有效的血液保护方法.现就其优点、适应证、禁忌症及其影响作一综述.     

自体血回输的护理进展

对自体血回输的研究进展进行全面的概括，内容主要包括自体血回输的分类、采集方法、适应证、禁忌证、并发症及预防、护理措施等。     

267例腹腔血自体回输的体会

本文报告了1974年以来我院收治的267例腹腔内出血患者行腹腔血自体回输的体会。回输自体血总量达238,810ml,占其术中输血量的90％。平均每人回输自体血895ml,最多者一次回输自体血3600ml,除1例死于创伤失血性休克外,余266例均治愈,无不良反应。作者认为自体血回输具有其特殊的优越性,避免了临床输异体血所带来的许多弊端,部分解决了血源短缺,对失血性休克患者的抢救起到了重要作用。提出了自体血回输的适应证和禁忌证。     

腹腔血自体回输58例的处理体会

2000～2005年我院共收集腹腔内出血回输58例，总量达52142ml，占其术中输血量的90％，能迅速纠正失血容量，对保证手术患者的生命安全起到重要的作用，现总结讨论如下。     

自体血回输的护理进展

对自体血回输的研究进展进行全面的概括,内容主要包括自体血回输的分类、采集方法、适应证、禁忌证、并发症及预防、护理措施等.     

对骨科手术中自体血回输的体会

本科自 2 0 0 0年 12月～ 2 0 0 1年 4月在骨科 2 4例手术中应用了自体血液回输技术 ,体会如下 :骨科大部分手术 (除肿瘤和感染 )的术中失血都可以回收再用。而以往术中估计失血量超过 10 0 0ｍｌ,除给予补晶、胶体液外 ,还需输同种异体血。输异体血会引起许多严重并发症。如 :非溶血性发热反应、细菌污染反应、艾滋病、肝炎等传染病。特别要强调的是输血后传染病 ,由于目前技术水平所限 ,对于传染病潜伏期内病人所献的血还很难查出 ,这部分血液及血液制品会造成输血者被感染的严重后果。 10 0多年前就有人提出自体血回输 ,而直到 2 0世纪 8…     

术中自体血回输研究进展

背景 术中自体血回输(intraoperative salvage autotransfusion,ISA)是通过回输术中失血以满足患者自身的血容量,减少异体输血并发症的一种血液保护措施.目的 分析总结近年来ISA研究的相关文献资料.内容 就其发展历程,对红细胞、血常规、凝血功能、免疫、肝肾功能、机体内环境的影响以及临床应用新进展作一综述.趋向 ISA对机体的影响及其防治方法,有待进一步研究.     

肝破裂腹腔血自体回输体会

肝破裂是严重的腹部外伤。早期主要的危险是内出血引起的失血性休克,及时有效地补充血容量非常重要。我院1990年2月至1993年8月共抢救肝破裂9例,采收腹腔血自体回输,克服血源不足,赢得抢救时机。报告如下:     

心胸创伤病人自体血回输对机体免疫系统的影响

随着免疫学的发展 ,特别是对自身免疫认识的深入〔1〕 ,自体血回输对机体免疫系统的影响受到关注 ,但研究还缺乏系统性〔2〕。现将我们的研究结果报告如下。资料和方法　选择 60例病人 ,其中回输血组2 0例 ,为胸部创伤致中等量血胸、伤后不足 2 4h、需输血治疗者和心脏术后纵隔、胸腔引流血量大于5 0 0ml者 ,平均回输血量 75 8ml;输库血组 2 0例 ,为胸部创伤或心脏术后输库存血的病人 ,平均输浓缩红细胞 (CRBC) 2 5 5U、血浆 895ml、全血 4 0 0ml;未输血组 2 0例 ,为创伤后失血量不大 ,不需输血治疗的病人。输血组于输血前、输血后 1、3…     

Zonal origin of localized prostate cancer does not affect the rate of biochemical recurrence after radical prostatectomy

OBJECTIVE: To investigate whether transition zone (TZ) prostate cancers demonstrate different rates of biochemical recurrence after radical prostatectomy compared to peripheral zone (PZ) cancers. METHODS: In 1262 consecutive patients treated with radical prostatectomy, computerized planimetry defined tumour origin as either TZ tumours (>70% TZ location) or PZ. Kaplan-Meier and multivariate Cox regression models tested the association between zonal origin and the rate of biochemical recurrence (prostate-specific antigen >0.1ng/ml and rising). We used the Harrell's concordance index to quantify the accuracy of various Cox regression models. RESULTS: TZ prostate cancers were diagnosed in 115 patients (9.1%). Biochemical recurrence was recorded in 16 TZ and in 201 PZ prostate cancers patients. In multivariate Cox models, the rate of biochemical recurrence was not significantly different between TZ and PZ prostate cancers (p=0.4). Combined multivariate predictive accuracy of biochemical recurrence predictions was 81.2% accurate when zonal origin was included versus 81.0% when zonal origin was omitted. CONCLUSIONS: The zonal origin of prostate cancers does not affect the rate of biochemical recurrence after radical prostatectomy.     

Interval to biochemical recurrence following radical prostatectomy does not affect survival in men with low-risk prostate cancer

Objectives

To evaluate the temporal relationship between interval to biochemical recurrence (BCR) following radical prostatectomy (RP) and prostate cancer-specific mortality (PCSM).

Patients and methods

The study comprised of 2,116 men from the Victorian Radical Prostatectomy Register, a whole-of-population database of all RPs performed between 1995 and 2000 in Victoria, Australia. Follow-up prostate-specific antigen and death data were obtained via record linkage to pathology laboratories and the Victorian Registry of Births, Deaths and Marriages. Poisson regression models with PCSM as the outcome were fit to the data. Models included age at surgery, Gleason score and tumour stage as covariates.

Results

Median post-surgery and post-BCR follow-up was 10.3 and 7.5 years, respectively. 695 men (33 %) experienced BCR during follow-up, of which 82 % occurred within 5 years of RP; 66 men died from prostate cancer. Men with combined high Gleason sum (≥4 + 3) and extra-prostatic (≥pT3a) disease had substantially increased mortality rate with early BCR, while those experiencing BCR after a longer interval had significantly lower mortality. Men with combined low Gleason sum (≤3 + 4) and organ-confined disease (≤pT2c) risk disease were not at any substantial risk of death in this time frame regardless of timing of BCR following RP.

Conclusions

This study evaluates the temporal relationship between BCR and PCSM using a whole-of-population cohort of men treated with RP. Men with low-risk features of prostate cancer at time of RP have low mortality even if they experience early BCR. This subgroup may be counselled regarding their favourable long-term prognosis.     

Salvage radical prostatectomy for recurrence of prostate cancer after radiation therapy

The goal of primary radiation therapy in the treatment of prostate cancer is to eradicate all of the local tumor. Although patients with relapsing disease after radiation therapy differ in their risk of death from prostate cancer, many will develop local progression, metastasis, and death. The recognition that local recurrence after radiation therapy portends a poor prognosis has led to the development of improved methods for early detection of recurrence and the development of alternative treatment strategies for radioresistant cancers. This article reviews knowledge regarding radiation failure and the role of salvage radical prostatectomy for men with local recurrence after radiation therapy for prostate cancer.