850例全血捐献者血管迷走神经反应观察

目的对全血捐献中发生血管迷走神经反应的影响因素进行分析,为采取针对性措施提供依据。方法以2017年1～12月在天津地区发生血管迷走神经反应的全血捐献者为研究对象,从性别、年龄、献血状态、反应程度、反应类型及其相关因素等方面进行分析。结果全血捐献者共118 370人次,发生血管迷走神经反应850人次(0.72%),不同性别(男女分别为0.54%和1.2%)、年龄(30岁和≥30岁分别为0.84%和0.53%)、献血情况(初次和再次献血分别为0.78%和0.52%)相比差异均有统计学意义(P0.01)。94.37%为轻度反应,表现为苍白、出汗、眩晕等,主要发生在采血结束后。反应程度与采血中相比差异有统计学意义(P0.05)。反应相关因素前3位为:精神紧张(43.76%),空腹献血(30.47%)和自身状态不佳(20.00%)。结论年轻女性,尤其是初次献血者,较容易在采血结束后出现血管迷走神经反应,可采取针对性措施进行预防,以利于无偿献血者的保留。     

血管迷走神经性献血反应的相关因素分析

目的探讨血管迷走神经性献血反应的相关影响因素,为制定有效的干预措施提供依据。方法回顾性调查2013年1月至2017年12月宜昌市献血人群,其中发生的490例血管迷走神经性献血反应的献血者资料,分析影响血管迷走神经性献血反应的相关因素。结果初次献血、低年龄(18-24岁)、学生、男性、低体重(<55 Kg)、街头献血是血管迷走神经性献血反应发生的影响因素,且影响程度依次为初次献血(OR值6.141,95%CI 4.908—7.684)、低年龄(OR值3.271,95%CI为2.735—3.912)、学生(OR值2.811,95%CI为2.277—3.470)、低体重(OR值1.345,95%CI为1.121—1.614)、男性(OR值1.254,95%CI为1.038—1.515)、街头献血(OR值1.245,95%CI为1.034—1.498)。结论心理因素是影响血管迷走神经性献血反应发生的主要因素,在献血全过程中应特别注意对初次献血、低年龄(18—24岁)、学生献血者的心理护理,采取针对性的预防措施,保障献血者安全。     

献浆相关血管迷走神经反应风险因素分析

目的 探讨献浆相关血管迷走神经反应(VVR)发生的风险因素,以此提出临床建议,实现对高危人群的早期识别、精准干预,保障献浆安全。方法 采集2019年7～12月四川某地区献浆人群人口学特征(性别、年龄、体重)及献浆记录(献浆史、献浆前脉搏、采集持续时间等),基于logistic回归分析,探究这些因素与VVR发生风险的相关性。结果 本研究共采集69 172例献浆者信息,VVR发生率为7.04‰。血浆采集持续时间<30 min组与>50 min组相比,发生VVR的风险可降低99%(OR=0.01; 95%CI,0.00～0.01;P<0.001);男性组与女性组相比发生风险可降低94%(OR=0.06; 95%CI, 0.04～0.10;P<0.001);体重大于80 kg组与45～50 kg组相比发生风险可降低80%(OR=0.20; 95%CI, 0.09～0.42;P<0.001),重复献浆组与首次献浆组相比发生风险可降低34%(OR=0.66; 95%CI, 0.47～0.91;P<0.05);献浆前脉搏大于90 bpm组的VVR发生风险是60～6...     

合肥地区献血相关迷走神经反应影响因素分析

目的 探讨合肥市无偿献血全血中发生献血相关血管迷走神经反应的影响因素及其特征分析,并针对性的提出预防措施。方法 以2021年1月至2021年12月合肥地区发生献血相关血管迷走神经反应的全血捐献者为研究对象,对性别、年龄、献血月份、初再次献血以及献血量、献血地点、献血组织方式等相关因素进行回顾性分析。结果 2021年合肥市无偿献血全血中献血相关血管迷走神经反应发生率为10.46‰,其中发生在血液采集过程中的献血相关血管迷走神经反应占71.89%。献血相关血管迷走神经反应在献血年龄、献血史、采血月份、献血组织方式、献血量等方面比较,差异有统计学意义(P<0.05);在性别、采血地点等方面比较,差异无统计学意义(P>0.05)。平衡年龄因素后,18岁～22岁、23岁～29岁献血人群不同性别之间DRVR发生率差异无统计学意义(P>0.05),30岁～39岁、40岁～49岁、50岁～60岁献血人群不同性别DRVR发生率不同(P<0.05)。不同年龄段献血人群中,初次献血者与重复献血者DRVR发生率均存在统计学差异(P<0.05)。结论 全血献血过程中要注意献血者人群...     

我国献血相关血管迷走神经反应发生率的系统评价与Meta分析

目的 通过Meta分析系统评价献血相关血管迷走神经反应(donation related vasovagal reaction, DRVR)在国内的发生率,并探讨DRVR的风险因素,为开展DRVR相关预防与控制工作提供科学依据。方法 计算机检索Cochrane Library、PubMed、WanFang Data和CNKI等相关数据库,搜集有关我国全血捐献DRVR发生率及危险因素的研究,发表时间为1998～2020年。由2位研究人员按照纳入与排除标准独立筛选文献、提取资料和评价纳入文献质量后,采用Stata软件进行Meta分析。结果 共纳入了63项研究,涉及6 043 945名献血者。DRVR的发生率为1.0%[95%可信区间(CI),0.9～1.1,I²=99.7%,P<0.01]。女性DRVR发生率(1.4%,95%CI:1.0～1.8,I²=99.6%,P<0.01)高于男性(1.1%,95%CI:0.8～1.4,I²=99.6%,P<0.01)。年龄方面,18～25岁献血者DRVR发生率为1....     

影响我国大学生血管迷走神经性献血反应相关因素分析

在校大学生是无偿献血的重要人群,在许多地方,他们甚至是最稳定和最可靠的血源。然而相关研究证实,在校大学生所处的年龄段,血管迷走神经性反应(vasovagal reac-tions,VVRs)发生率远高于成年人群[1]。很多积极参加献血的大学生由于在首次献血时(或献血后)发生VVRs,而不愿或害怕再次献血,以至影响无偿献血工作的进一步开展。因而,弄清大学生与WRs高发的相关因素,提出合理的方案降低其反应率,具有重要意义。笔者回顾性分析了大学生高VVRs发生率与献血者性别、体重、献血量和献血次数等因素的关系,并初步提出降低该反应率的若干建议。1资…     

成分献血者献血反应的多因素分析

伴随着恶性肿瘤、恶性血液病、大手术的开展，临床对单采成分，特别是单采血小板的需求益增多。单采成分是自单一献血者体内采集高浓度的某一种血液成分，这部分献血者称之为成分献血者；与全血献血者相比，成分献血者在采集过程中，更易发生头晕、冒汗、胸闷、恶心、呕吐、寒战、晕厥等献血反应，此类献血反应通称为血管迷走神经反应（Vasovagal reactions，WRs）.     

机采血小板献血者与全血献血者献血反应的比较

机采血小板具有浓度高、纯度高、红细胞及白细胞少、疗效肯定等优点,在临床上越来越受到医务人员及病人的欢迎.但机采血小板同样也存在献血反应的问题,由于采集方法不同,机采血小板献血者的献血反应与献全血者的献血者反应不完全相同.本研究通过观察和比较机采血小板献血者及献全血者的不同的临床症状,探讨机采献血者与全血献血者献血反应的特点.     

Prevalence of immediate vasovagal reaction in blood donors visiting two blood banks of Karachi

Vasovagal reaction (VVR) is a very common adverse event related to blood donation. No study has been conducted in Pakistan to estimate the prevalence of VVR in blood donors. This study was conducted to estimate the prevalence of immediate VVR in blood donors of Karachi, Pakistan. The study was conducted in two blood banks of Karachi. Data regarding the development of immediate VVR were documented. The effect of blood donation on vital parameters like pulse rate, blood pressure (BP), temperature and respiratory rate was also observed. Six hundred and seventy‐four blood donors were recruited. All the donors who consented were males. Weakness and dizziness were two most common symptoms which were reported by 91 (13.5%) and 73 (10.8%) of the participants, respectively. Out of 91 donors in whom signs and symptoms of immediate VVR were observed, a significant drop in systolic BP (13.5 ± 2.5 mmHg) and decrease in pulse rate (13.3 ± 3.6) were concurrently noted in 55 donors (8.2% of all the participants). There was lack of association of age, body mass index (BMI), estimated blood volume, ethnicity, educational status, profession and first time donation status with the frequency of VVR. Only marital status was found to be significantly associated with higher frequency of immediate VVR, where married donors were having higher odds as compared to singles. The prevalence of VVR in the blood donors at two blood banks of Karachi is at least 8.2%. Furthermore, married men are at more risk of experiencing VVR in our population.     

Interventions to reduce vasovagal reactions in blood donors: a systematic review and meta‐analysis

Vasovagal reactions (VVRs) in blood donors have significant implications for the welfare of donors, donor retention and the management of donor sessions. We present a systematic review of interventions designed to prevent or reduce VVRs in blood donors. Electronic databases were searched for eligible randomised trials to March 2015. Data on study design and outcomes were extracted and pooled using random effects meta‐analyses. Sixteen trials met the inclusion criteria: five trials (12 042 participants) of pre‐donation water, eight trials (3500 participants) of applied muscle tension (AMT) and one trial each of AMT combined with water, caffeine, audio‐visual distraction and/or social support. In donors receiving pre‐donation water, the relative risk (RR) compared with controls for VVRs was 0·79 [95% confidence interval (CI) 0·70–0·89, P < 0·0001] and the mean difference (MD) in severity of VVRs measured with the Blood Donation Reactions Inventory (BDRI) score was ?0·32 (95% CI ?0·51 to ?0·12, P < 0·0001). Excluding trials with a high risk of selection bias, the RR for VVRs was 0·70 (95% CI 0·45–1·11, P = 0·13). In donors who received AMT, there was no difference in the risk of chair recline in response to donor distress from controls (RR 0·76, 95% CI 0·53–1·10, P = 0·15), although the MD in BDRI score was ?0·07 (95% CI ?0·11 to ?0·03, P = 0·0005). There was insufficient data to perform meta‐analysis for other interventions. Current evidence on interventions to prevent or reduce VVRs in blood donors is indeed limited and does not provide strong support for the administration of pre‐donation water or AMT during donation. Further large trials are required to reliably evaluate the effect of these and other interventions in the prevention of VVRs.     

北京地区全血献血者铁蛋白调查分析

目的 对北京地区全血献血者铁蛋白检测,分析与铁蛋白低值异常相关的影响因素,为全血献血者科学补铁提供依据.方法 以2018年3-6月北京地区27 071名全血献血者为研究对象,进行铁蛋白检测.使用Logis-tics 回归分析影响铁蛋白低值异常的献血者相关信息,确定最容易出现铁蛋白低值异常的全血献血者类型.结果 北京地区...     

Interventions to reduce the vasovagal reaction rate in young whole blood donors

BACKGROUND: There have been multiple reports concerning the predictors of fainting reactions in blood donors, but few attempts to reduce the rates of fainting reactions with concomitant rigorous attempts to monitor the success of the interventions. STUDY DESIGN AND METHODS: We used a retrospective observational cohort study design, comparing the likelihood of reaction from 213,031 allogeneic whole blood donations made by 17‐ to 22‐year‐old donors in two separate 12‐month periods before and after the implementation of interventions to reduce reactions. The interventions were 1) a limit on the maximum percentage of estimated blood volume young donors could donate, 2) encouraging applied muscle tension during donation, and 3) providing approximately 500 mL of water before donation. Reactions were defined by severity and time in relation to the end of phlebotomy and documented according to standard procedures. Data analysis included comparison of stratified reaction rates and multivariable logistic regression analysis. RESULTS: The interventions decreased the aggregate reaction rates in male and female donors by 24% (p < 0.0001). There was a 25% decrease in delayed reactions (p = 0.0006) and a 38% decrease in off‐site reactions (p = 0.001) in female donors. The impact of the three interventions together on reaction rate was greater than the combined impact of exercises and water provision. Multivariable modeling showed that the interventions reduced reactions but did not prevent their occurrence in identified higher risk groups. CONCLUSION: The interventions to reduce vasovagal reactions in whole blood donors were effective. Future efforts to reduce reactions in blood donors can build on the strengths and avoid the weaknesses identified while conducting and analyzing the data from this study.     

北京地区56-60周岁全血献血人群的特征分析

目的研究分析56-60岁献血人群的基本特征,为我国安全实施推广高龄献血者的招募保留提供数据支持和参考。方法回顾性分析2012年7月1日-2016年6月30日在北京市红十字血液中心献血者的资料,将18-55岁献血人群为对照组,56-60岁人群为研究对象,分析其献血次数、性别、献血频率、献血量选择、延迟献血率、献血不良反应率等特征。结果观察期间年龄在56-60岁之间献血者共4 134名参加登记献血,其中男2 692名,女1 442名,共计登记献血次数为5 916人次,登记献血频率(5 916/4 134,1.431)高于对照组的(1 220 889/1 176 193,1.038),且每年献血人次逐年增加;400 mL献血量比(3 937/1 979, 1.989)显著低于对照组(1 070 718/150 171, 7.130);延迟献血率和献血反应发生率与18-55岁年龄组无统计学差异(P>0.05)。结论既往无献血反应的56-60周岁献血者继续献血是安全的,其献血量逐年增多,针对这部分人群的献血动员招募是我国献血人群管理的重要组成部分,应针对该人群的献血行为特征,制定精准的献血招募保留策略。     

Vasovagal reactions in blood donors during or immediately after blood donation

The aim of the study was to estimate the type, incidence and causes of donor adverse reactions during and after blood donation in a Greek Blood Bank, where medical staff is responsible for donor selection. 12 173 blood donors were studied for adverse reactions. One-hundred and seven (0.87%) donors had a vasovagal reaction during or after blood donation. Donors who gave blood occasionally had a significant greater incidence of reactions compared with volunteer donors (1.15 versus 0.53%) (P < 0.001). There was no significant difference between men and women (0.85 versus 0.95%). First-time donors (1.7 versus 0.68%) and those under 30 years (1.15 versus 0.71%] had a significant greater possibility to have a reaction (P < 0.001). Twenty-two of 107 (20.5%) donors had a syncopal reaction. There was not a causative correlation of haematocrit, haemoglobin, systolic and diastolic blood pressure, pulse rate and weight in women (except weight in men) in developing a reaction. The stressing experience of phlebotomy was the reason for the higher frequency of a reaction. The incidence of reactions in our donors is lower than in other studies, and the possible reason for this is that only physicians are responsible for the selection of donors and trained personnel are careful of them during the donation process.