缩短机采血小板献血间隔期前后献血者的血常规变化分析

目的:分析机采血小板固定献血者缩短献血间隔期前后血常规的变化,了解对献血者健康的影响。方法:随机抽取40名机采血小板固定献血者为研究组,监测献血间隔期从≥4周缩短到≥2周前后的血常规,以及同期首次机采血小板献血者对照组40名血常规进行分析。结果:研究组缩短献血间隔期前后血常规变化差异均无统计学意义(均P0.05),研究组缩短献血间隔期前后血常规与同期首次机采血小板献血者的血常规比较,WBC、RBC和Hb的差异均无统计学意义(均P0.05),MPV、HCT和PLT差异有统计学意义(P0.05)。结论:缩短献血间隔期前后,机采血小板固定献血者自身血常规变化差异无统计学意义(P0.05),与同期首次机采血小板献血者的血常规比较,WBC、RBC和Hb差异无统计学意义(P0.05),MPV、HCT和PLT下降,但均在正常范围。缩短献血间隔期对献血者健康无明显影响。     

血小板捐献频次对献血者血常规指标的影响

目的 观察2周捐献一次血小板对血常规指标的影响.方法 观察对象为65例每2周捐献一次血小板、每次捐献2个治疗量的自愿献血者,检测其献血前、献血后2周及连续献血6次后2周血常规指标变化.结果 捐献血小板后白细胞计数、淋巴细胞计数、红细胞计数、血红蛋白、血小板计数等与献血前比较无统计学差异.结论 2周捐献一次血小板对机体血常规指标无明显影响.     

台州市机采血小板状况分析

目的:对台州地区机采血小板情况进行分析,以便有针对性的制定适合本地实际情况的献血宣传方式,有效保留和招募机采血小板献血者,确保本地区机采血小板的临床供应。方法:对台州地区2009-2013年机采血小板采集的情况(包括机采血小板献血者年龄、性别、血型,淘汰原因等)通过office excel、SPSS 20.0软件进行分析。结果:台州无偿成分献血人口比例高于2011年全国水平,男性远多于女性,年龄多分布于26~45岁,血型分布与台州地区人口血型分布基本一致,在各个淘汰指标中丙氨酸氨基转移酶和全血白细胞计数的淘汰率较高。结论:台州地区无偿捐献机采血小板的工作中,可加强对年轻人群及女性的宣传号召力度,继续提高献血者的主动屏蔽意识,以减少成分献血的淘汰率。     

机采血小板采集失败原因分析及改进措施

目的:探讨导致机采血小板采集失败的影响因素并加以改进,以减少采集失败的发生率。方法:统计分析改进前后研究区间内的机采血小板资料,将失败案例汇总,分析原因。结果:原因共分为6类,其中献血者血细胞常规计数异常、乳糜血、献血不良反应、穿刺不成功及血肿是造成采集失败的主要原因,机采血小板采集失败总发生率为1.0%、血常规异常、乳糜血和血肿比改进前低(χ~2=40.728、72.102、14.598、8.173,P0.05),而献血不良反应、穿刺不成功和其他在改进措施前后比较差异无统计学意义(χ~2=1.218、3.110、0.386,P0.05)。结论:机采血小板采集失败大多由献血者筛选过程不合理和工作人员操作失误导致。通过加强采集前检测分析与献血者筛选、采集时密切观察以及改进操作,可以有效规避。     

机采血小板采集过程的影响因素探讨

目的:探讨机采血小板采集过程的影响因素,以便监测和控制,使能更好地为献血者服务。方法:对我站2013年3月330例献血者整个机采过程进行观察和记录。结果:献血者采前血小板计数,血细胞比容等血液参数,以及性别,体重,血管,环境温湿度,采血技术等与机采采集过程和产品质量密切相关。结论:加强采前宣教,认真筛选合适献血者;创造适宜的环境;提高采血人员的操作技术,提高全程服务质量。能使机采过程顺利进行,缩短机采时间,减少献血不良反应的发生,巩固和扩大机采献血者的队伍。     

浅谈心理护理在捐献机采血小板者中的应用

目的：通过对初次无偿机采血小板捐献者采取心理护理干预,分析心理护理干预对初次无偿机采血小板捐献者的保留,并发展为固定捐献者的影响。方法：对2006—2008年842人来本站初次捐献机采血小板者实施献血前、中、后心理护理干预。结果：2006、2007、2008年采取心理护理干预后初次献血者保留为固定献血者所占比例分别为47.95%、72.33%、87.36%。结论：对机采血小板捐献者采取心理护理干预,有利于机采血小板捐献者的保留,对稳定固定机采血小板队伍有着重要的作用。     

潮汕地区机采血小板献血者采集前后相关血常规的分析

目的：分析机采血小板献血者采集前后不同时段相关血常规的计数，探索采用Trima5．1血细胞分离机及配套耗材采集单剂量和双剂量血小板安全可行的间隔期。方法：把外周血小板计数为170×10^9／L～230×10^9／L捐献单剂量血小板（3．0×10^11个）的献血者30例定为1组，把血小板计数为250×10^9／L～300×10^9／L捐献双剂量血小板（6．0×10^11个）的献血者30例定为2组，采用SPSS10．0统计软件对献血者采前、采后不同时段相关血常规计数进行比较分析。结果：2组献血者在采后30min血小板计数较采集前明显下降，差异有统计学意义（P〈0．05），在采后15、30d分别对2组献血员进行血细胞计数，1组献血者血小板的计数已恢复到采集前的水平，与采集前相比差异无统计学意义（P〉0．05）；2组献血者采后15d，血小板计数仍未能上升到采集前水平，与采集前相比差异有统计学意义（P〈0．05）；但在采后30d血小板的计数已恢复到采集前的水平，与采集前相比差异无统计学意义（P〉0．05）。而2组献血者RBC、HGB、HCT、WBC在不同时段与采集前相比差异无统计学意义（P〉0．05）。结论：2组献血者采后30min外周血小板计数全部〉100×10^9／L，血小板计数在正常范围；献血者机采前血小板计数〉170×10^9／L，捐献单剂量血小板的间隔期为15d是安全的；双剂量血小板捐献者采前血小板计数必须〉250×10^9／L，间隔期应为30d。     

以定制化服务发展固定成分献血者队伍

机采成分献血是无偿献血的另一种捐献形式。招募机采成分献血者是无偿献血工作的重要组成部分,但由于受机采成分献血者健康状况要求较高、采集时间较长、需要特殊设备、     

单采血小板采集2个治疗单位献血者筛选指标探讨

目的:探讨机采血小板采集2个治疗量献血者筛选指标。方法:对78例献血者分析其体重、体表面积和采前血小板(PLT)计数对血小板减少量的影响。结果:体重(W)≥55kg,体表面积(S)≥1.7,采前血PLT计数≥200×109/L者采集后血小板计数均≥100×109/L。对男性献血者来说W≥70或S≥1.9采集后血小板降低较少;对55≤W<65,1.7≤S积<1.8献血者来说,采后血小板降低较多。结论:机采血小板采集2个治疗单位献血者筛选时要求W≥55kg,S≥1.7,采前血PLT计数≥200×109/L。     

机采血小板采集失败的原因分析及处理措施

目的:通过对机采血小板采集失败原因的分析,探讨采取合适的措施,降低机采血小板采集的失败率,避免或降低对献血者的伤害,降低机采血小板的成本。方法:对2005-2012年机采血小板采集失败情况进行统计,并对其各种原因进行分析。结果:其间机采血小板采集失败共计68例,失败率为0.31%。具体原因有血小板冲红,脂肪血,采血部位血肿,献血反应,溶血等。其他与耗材安装不到位,耗材质量(扭曲,渗漏),机器故障等有关。结论:对机采血小板采集失败等原因进行细化分析,总结经验,有利于在以后的工作各环节中有效的处理和规避,不仅有效地减少血液报废比率,降低机采血小板成本,也为献血者的安全和临床用血质量提供了有力的保障。     

关于采供血机构预测采后血小板数方法的探讨

目的:对采供血机构单采血小板后血小板预测数的方法进行探讨。方法:通过对30例单采血小板献血者进行采前公式计算预测采后血小板数和采后血小板计数的方法来验证采前预测是否相对准确。结果:通过采后检测和用公式计算比较,两者差异无统计学意义。结论:预测采后血小板数是保护献血者安全的一项重要措施,通过采前一定方法的计算,可以预测采后血小板数,从而保护献血者。     

东莞市街头无偿献血者知信行调查分析

目的:了解东莞市街头献血者对无偿献血的相关知识和政策的认知水平、态度和行为状况,为我市无偿献血工作的改进和优化提供科学依据。方法:采用自制调查问卷对我市街头献血者进行调查,内容包括无偿献血相关知识和政策、献血动机、担心的问题、了解无偿献血的途径。结果:初次献血者和重复献血者在绝大部分调查项都有显著性差异。重复献血者对无偿献血政策、血液和献血知识的了解程度要远远高于初次献血者,"新闻媒体和公益广告"在献血者了解途径中均排在第一位,"家人、亲戚朋友"在初次献血者的了解途径中占有相当重要的地位。"献爱心"和"献血有益健康,免费体检"在献血动机中均排在前两位,"其他(好奇,查血型,减肥等)"在初次献血者的动机中占了很大一部分比例。初次献血者最担心的问题是"影响健康、工作和生活",而重复献血者最担心的是"血液去向及是否得到合理利用"。结论:根据此次调查结果,运用社会营销原理、心理咨询和马斯洛需求层次理论,有目的和针对性地进行宣传和招募,能促使献血者由知向信进而行为的转变。     

患者亲属互助献血与街头自愿无偿献血相关因素对比分析

目的：探讨患者亲属互助献血与街头自愿无偿献血的差异。方法：对2类不同献血类型的相关因素对比分析。结果：①患者亲属互助献血人员构成与年龄及受教育程度无关,而自愿无偿献血者以25岁年轻人为主体,献血积极性与文化程度高低成正比,且比例明显高于互助献血者。②互助献血献血反应发生率及卫生部规定的4项血液传播性疾病检测阳性检测率明显高于自愿无偿献血者。结论：患者亲属互助献血多从亲情和友情角度出发,多属有目的的被动献血,只能做为无偿献血血源紧缺及偏型的暂时补充,目前无偿献血的宣传工作,应针对不同人群加大宣传力度和广度,使这部分人自愿加入到无偿献血的队伍中来。     

机采血小板献血者淘汰原因分析及对策

目的:通过对机采血小板献血者各种淘汰原因及影响因素分析,探讨采取合适的措施,降低献血者淘汰率,充分利用血源资源。方法:对2013-01-01-2013-12-31期间来站登记捐献血小板者淘汰情况进行统计,并对其各种原因进行分析。结果:台州市中心血站2013年全年机采血小板献血者总淘汰率为18.02%,征询、体检、血液初筛各环节淘汰率分别为2.39%、2.77%、12.86%。具体淘汰原因在各环节并有次数、性别、季节的不同。结论:对机采血小板献血者采前筛查各个环节淘汰原因进行细化分析,有利于在招募和献血服务过程中,有针对性的对献血者进行宣教、答疑和干预。达到提高机采采前合格率和长久保留献血者,降低经济和社会成本的目的。     

Influence of multicomponent apheresis on donors' haematological and coagulation parameters, iron storage and platelet function

Background and Objectives Multicomponent collection (MCC) enables production and processing of various blood components during one apheresis session. In this prospective crossover study, the effects of donating platelets (PLTs) and packed red blood cells (PRBCs) on donor’s blood cell count, coagulation, PLT function and iron state were analysed. Materials and Methods Forty‐eight MCCs were performed using two different cell separators (Fenwal Amicus^®, CaridianBCT Trima Accel^®). Two units of platelet concentrates and one unit of PRBCs were collected during each session. Full blood cell count and iron status were obtained on day 0 before and after apheresis, day 2, day 14 and day 42. PLT function was analysed by aggregometry and rotation thromboelastometry in parallel with coagulation tests before and after MCC and at day 2. Results Multicomponent collection was well tolerated without adverse side effects. Blood cell count and iron parameters declined and most of them (haemoglobin, haematocrit, transferrin, transferrin saturation and ferritin) were significantly below baseline values until at least day 42 after donation. Absent iron stores were seen in 31·3% of the donors. In contrast, PLTs significantly exceeded pre‐donation values after 14 days and remained significantly increased for 42 days. After 2 days, coagulation parameters were only slightly (P > 0·05) altered, whereas PLT function was significantly reduced. Conclusion Multicomponent collection is an obviously safe procedure; however, the significant long‐term impact on the donor’s blood count and iron store, as well as impaired PLT function, has to be considered in regard to donor safety.     

储存式自体输血在前置胎盘患者中应用的安全性分析

目的:通过研究储存式自体输血对前置胎盘患者血红蛋白(Hb)、血细胞比容(HCT)、血小板(PLT)以及凝血功能的影响,探讨储存式自体输血在前置胎盘患者中应用的安全性。方法:收集2012-03-2013-09在孝感市中心医院住院的20例前置胎盘患者,比较其在进行储存式自体输血前后Hb、HCT、PLT以及凝血指标的变化有无显著性。结果:采血前后及血液回输后各项血液及凝血指标差异均无统计学意义;新生儿血常规及凝血指标均无异常;19例患者进行自体回输后均无不良反应。结论:储存式自体输血对自身状态良好、满足储存式自体输血基本要求的前置胎盘孕妇母婴均安全,不影响孕妇妊娠结局。     

Donation of stem cells from blood or bone marrow: results of a randomised study of safety and complaints

Biological consequences and physical complaints were compared for donors randomly assigned either to blood stem cell (BSC) or bone marrow (BM) donation. In the period 1994-1999, 61 consecutive donors were included. The BSC donors were given G-CSF 10 microg/kg s.c., daily during 5 days before the first leukapheresis. Nineteen donors had one leukapheresis, 10 required two and one donor needed three leukaphereses in order to reach the target cell number of 2 x 10(6) CD34(+) cells/kg bw of the recipient. A median platelet nadir of 102 x 10(9)/l was reached shortly after the last leukapheresis. Three weeks post harvest, 17 of 30 BSC donors had a mild leukopenia. Six had a leukopenia lasting more than a year before returning to normal values. Both groups were monitored prospectively through a standardised questionnaire completed by the donors. BSC donation was significantly less burdensome than BM donation and was preferred by the donors. The short-term risks of BSC mobilisation and harvest seem negligible. The potential long-term effects of G-CSF are unresolved and the donors must be followed closely.     

Factors associated with granulocyte colony-stimulating factor-induced peripheral blood stem cell yield in healthy donors

BACKGROUND AND OBJECTIVES: Poor collection results are a clinical problem in granulocyte-colony stimulating factor (G-CSF)-induced peripheral blood stem cell (PBSC) collection in healthy donors. It would be beneficial to be able to predict the PBSC yield from allogeneic donors before mobilization or harvesting. MATERIALS AND METHODS: We examined the relationship between certain donor characteristics and the effectiveness of G-CSF-induced PBSC collection in 59 healthy family donors aged 3-63 years old (median 16 years). G-CSF was administered subcutaneously at 10 microg/kg for mobilization, daily for 5 days, and PBSC harvest using a continuous blood cell separator was started on day 5 of G-CSF treatment. Total cell yields were calculated as the number per unit of processed blood (l) per unit weight of the donor (kg). RESULTS: In a univariate analysis, the donor's age, body mass index (BMI), white blood cell (WBC) count before mobilization, and platelet count before and during mobilization were significantly correlated with the yield of mononuclear cells (MNC), CD34(+) cells and granulocyte-macrophage colony-forming units (GM-CFU). Younger age (P < 0.001), a low BMI (P = 0.002), a high WBC count before mobilization (P = 0.004), a high platelet count before (P = 0.012) and during (P < 0.05) mobilization, and a low speed of withdrawal (P = 0.019) were associated with a higher CD34(+) cell yield. No significant correlation was found for gender, the type of G-CSF, the serum level of G-CSF, the type of cell separator, or the type of blood access. A multivariate forward and backward stepwise selection regression analysis showed that the factors associated with CD34(+) cell yield were age, platelet count before and during mobilization, and circulating CD34(+) cell concentration on day 2 of G-CSF treatment. CONCLUSION: In this small preliminary study, we found that donor age is the most important factor in predicting G-CSF-induced PBSC yields. Old age and low platelet counts before mobilization might be useful indicators for identifying poor mobilizers. Further validation of these findings in a larger number of donors are needed to establish whether these findings apply to other populations.     

新生儿换血治疗49例分析

目的：探讨导致新生儿换血的病因,换血前后患儿胆红素水平及血常规、血生化等内环境指标的变化。方法：对49例北京儿童医院新生儿换血病例,统计分析导致换血病因;换血前后分别检测患儿胆红素、血生化、血气分析及血常规,并进行比较。结果：49例患儿中因母婴血型不合导致换血41例,遗传型球型红细胞增多症3例,红细胞葡萄糖-6-磷酸脱氢酶缺乏症2例,原因不明的高胆红素血症患儿3例。换血治疗前后血清总胆红素和间接胆红素水平下降52%,血小板、白细胞计数显著减少。患儿的血钾、血氨明显下降（P〈0.01）,血钠和血钙水平换血前后差异无统计学意义（P〉0.05）,但血糖水平显著升高（P〈0.01）。换血治疗前后血气分析指标无明显波动（P〉0.05）。结论：母婴血型不合是导致新生儿换血的主要原因。换血治疗新生儿高胆红素血症可以有效降低患儿体内胆红素水平,对患儿血液内环境有一定影响。