不扎止血带采集静脉血标本的临床效果观察

目的 观察不扎止血带采集成年患者静脉血标本的临床效果.方法 选择2016年7月至12月在本科住院的成年患者100例,按住院号的单双随机分为试验组与对照组,各50例.试验组与对照组均为首次抽血,试验组采集静脉血标本时按现有的常规全程扎上止血带,对照组只在穿刺血管时扎止血带,当确定穿刺针在血管内时即解除止血带,采集静脉血标本全程不扎止血带,两组患者采集静脉血标本达标率、扎止血带部位的疼痛程度、穿刺部位的不适程度、患者的满意度、穿刺局部皮下出血的发生率比较.结果 两组患者采集静脉血标本的达标率比较,差异无统计学意义(P＞0.05).患者扎止血带部位的疼痛程度、穿刺部位的不适程度、患者的满意度、穿刺局部皮下出血的发生率比较,差异有统计学意义(P＜0.05).结论 为患者采集静脉血标本期间不扎止血带可降低扎止血带引起的局部疼痛、降低穿刺部位的不适感、减轻局部皮下血肿、提高患者的满意度,但不影响静脉血标本采集的达标率,因此,成人采集静脉血标本期间可不扎止血带.     

采集新生儿足跟血方法的探讨

目的　探讨临床采集足跟血液的最佳方法。方法　将 2 5 2例新生儿随机分为观察组 12 7例 ,对照组 12 5例。观察组在常规采血的基础上给新生儿定时哺乳、沐浴、酒精按摩足跟后采集血液。对照组按常规要求采集血液。结果　观察组较较对照组的采血方法较为容易 ,且成功率高 ,新生儿痛苦小。两种方法差异非常显著 (P <0 .0 1)。结论　新生儿酒精按摩足跟采血方法简便易行 ,具有重要的实际应用意义     

不同血样采集管对血氨测定结果的影响

目的 :探讨四种血样采集管对血氨测定结果的影响。方法 :随机选择30例健康成年人的静脉血 ,分别将1 5ml血液注入四种血样采集管中 ,经离心分离后即提取血清或血浆进行血氨测定 ,同时观察分离胶真空分离器于4℃和20℃随时间延长血氨浓度的变化情况。结果 :(1)在相同条件下 ,四组血样采集管血氨测定结果相近的有EDTA -K2 管组、EDTA -Na2 管组和分离胶管组 ,而肝素管组血氨结果差异较大 ,P<0 05。(2)分离胶真空分离器血氨浓度在4℃8小时内几乎不变。结论 :不同血样采集管对血氨测定结果有一定影响 ,分离胶真空分离器作为血氨测定的血样采集管其测定结果较稳定 ,可推荐使用     

Assessment of blood collection systems for the high performance liquid chromatography measurement of propranolol

The effect of blood collection devices on the high performance liquid chromatography (HPLC) measurement of propranolol was assessed. Blood was collected from hypertensive patients treated with propranolol for at least 7 days. Two venipunctures (opposite arm technique) were performed on each patient using the reference (syringe/silanized, ethylene diamintetraacetate tubes) procedure and the Vacutainer Brand Tubes (lavender-, royal blue-, green-, and red-stoppered) that were free of tris(2-butoxyethyl) phosphate. Propranolol concentrations were determined utilizing a published HPLC procedure. This study showed that in the four evacuated tubes, propranolol concentrations in serum or plasma were highly correlated to those of the reference procedure (correlation coefficients, 0.986 to 0.997; and slope, 0.912 to 1.013). Mean propranolol concentrations of the red-stoppered tube serum were lower (7.5%) than that of the reference syringe (0.01 less than p less than 0.05). Thus, lavender-, royal blue-, green-, and red-stoppered tubes would be acceptable for propranolol monitoring.     

Effect of serum separator blood collection tubes on drug concentrations

Using the EMIT assay, we tested clinical samples from patients receiving 12 commonly monitored drugs to evaluate the effect of serum separator gel contained in serum separator blood collection tubes (SST) (Becton-Dickinson). There were significant concentration decreases for lidocaine, pentobarbital, and phenytoin. In vitro experiments demonstrated that this effect on phenytoin was dependent on time of exposure to the gel and volume of whole blood, but was not dependent on the presence of red blood cells or initial concentration. Bias attributed to the use of SST could interfere with the usefulness of clinical results at the upper and lower limits of the therapeutic range. This problem can be minimized by processing samples of at least 2 ml within 1 h.     

不同真空采血管对锌锂测定的影响

目的:评价不同真空采血管制备的血清对测量血锌锂结果的影响.方法:收集60例受检者的普通真空采血管、分离胶促凝真空管、肝素钠抗凝管以及分离胶促凝真空管制备血,其中30例从正在服用碳酸锂治疗的病人抽取,分析四种不同采血管处理的同一标本.结果:锌用4种采血管处理的结果差别无统计学意义,锂使用添加剂肝素钠和促凝剂处理的标本结果...     

Time-dependent absorption of therapeutic drugs by the gel of the Greiner Vacuette blood collection tube

Stability of therapeutic drugs in sera collected in Becton-Dickinson VACUTAINER serum separator SST tubes has been well studied. Recently, the Greiner Vacuette serum separator tube has become available for blood collection. However, stability of therapeutic drugs in sera when the specimen is collected in the Greiner tube has not been reported. The authors studied the stability of 15 commonly monitored drugs in sera when stored on the gel of the Greiner serum separator tubes. The drugs studied were amikacin, gentamycin, tobramycin, vancomycin, digoxin, quinidine, theophylline, carbamazepine, phenobarbital, phenytoin, valproic acid, tricyclic antidepressants, salicylate, acetaminophen, and ethanol. The authors compared the concentrations of drugs in sera stored in plain tubes (no gel) and in sera stored in the Greiner tubes containing serum separator gel. They observed a significant decline in the concentrations of tricyclic antidepressants when stored in the Greiner tubes. Interestingly, concentrations of amitriptyline declined more than its metabolite nortriptyline and concentration of imipramine also decreased more than its metabolite desipramine. The concentration of carbamazepine also decreased slightly over time when serum was stored in the Greiner tube. Although declines in carbamazepine concentrations on prolonged storage in the Greiner tubes were statistically significant, the decreases may not be clinically significant. The concentrations of the other drugs studied did not decline when stored in the Greiner tubes. The authors conclude that the Greiner brand tube is not suitable for blood collection for analysis of tricyclic antidepressants.     

针对性护理对标本采集质量的影响

目的：分析针对性护理对标本采集质量的影响。方法收集本院2011年1月～2012年1月行检验标本采集的1000人作为参考组（未实施针对性护理）,收集2012年2月～2013年2月行检验标本采集的1000人作为观察组（实施针对性护理）,比较两组护理问题的总发生率。结果观察组护理问题（标本量不足、患者准备不充分、标本留取不规范、送检不及时、其他）的总发生率明显低于参考组（P＜0.05）。结论在检验标本采集中,医护人员要采取有效措施,从而减少存在的问题,提高检验质量。     

Stability of drug concentrations in plasma stored in serum separator blood collection tubes

The stability of therapeutic concentrations of 11 drugs (amikacin, carbamazepine, digoxin, gentamicin, lithium, methotrexate, phenobarbital, phenytoin, quinidine, theophylline, tobramycin) and two trace elements (copper and zinc) in plasma stored in serum separator ("Corvac" brand) blood collection tubes was investigated over a 1 week period of storage in the refrigerator. No significant change in concentration was noted for any analyte during the study period. Concentrations were also not significantly different from those observed during concurrent storage of the same plasma samples in nonserum separator ("Vacutainer" brand) blood collection tubes.     

头皮针联合采血针真空采血法在新生儿股静脉采血中的应用效果

目的：探讨头皮针联合采血针真空采血法在新生儿股静脉采血中的应用效果。方法选取2012年10月~2013年10月本院收治的187例新生儿,将其随机分为对照组一(n=62)、对照组二(n=62)和实验组(n=63)。对照组一采用头皮针衔接注射器采血,对照组二采用真空采血针采血,实验组采用头皮针联合采血针真空法采血,3组采血均由固定的人员进行操作,比较3组的采血效果。结果实验组的一次性穿刺成功率为96.8%,高于对照组一的87.1%和对照组二的82.2%,组间差异有统计学意义(P<0.05或P<0.01);实验组的标本合格率为96.8%,显著高于对照组一的80.6%,组间差异有统计学意义(P<0.05);实验组的血肿发生率为0%,显著低于对照组二的8.06%,组间差异有统计学意义(P<0.05)。结论应用头皮针联合采血针真空采血法行新生儿股静脉采血,效果安全、成功率高,可减轻患儿痛苦,特别是早产儿、低体重儿、严重脱水新生儿,值得临床推广应用。     

Integrated sample collection and handling for drug discovery bioanalysis

An integrated sample handling process for drug discovery bioanalysis is described. The streamlining of study design, sample collection and automatic bioanalytical sample processing is demonstrated. Specific details for the entire procedure regarding the time saved, ease of automation and integration are defined. Details of sample handling involved a sample collection map, sample collection formatting and volume, dilution schemes for high concentration samples, choice of biological fluid and evaluating the capabilities of two liquid-handling workstations. Numerous comparisons were conducted between the new approaches and the conventional sample handling approaches. The precision and accuracy obtained from the new integrated sample handling process were comparable to those obtained from a conventional approach, as were pharmacokinetic profiles and parameters. This new sampling process greatly improved the efficiency of drug discovery bioanalysis. The integration of pre-clinical protocol design, sample collection and bioanalysis processes was also achieved.     

Key aspects of the Novartis compound collection enhancement project for the compilation of a comprehensive chemogenomics drug discovery screening collection

The NIBR (Novartis Institutes for BioMedical Research) compound collection enrichment and enhancement project integrates corporate internal combinatorial compound synthesis and external compound acquisition activities in order to build up a comprehensive screening collection for a modern drug discovery organization. The main purpose of the screening collection is to supply the Novartis drug discovery pipeline with hit-to-lead compounds for today's and the future's portfolio of drug discovery programs, and to provide tool compounds for the chemogenomics investigation of novel biological pathways and circuits. As such, it integrates designed focused and diversity-based compound sets from the synthetic and natural paradigms able to cope with druggable and currently deemed undruggable targets and molecular interaction modes. Herein, we will summarize together with new trends published in the literature, scientific challenges faced and key approaches taken at NIBR to match the chemical and biological spaces.     

Continuous transepidermal drug collection: Basis for use in assessing drug intake and pharmacokinetics

Continuous transepidermal drug collection (CTDC) has been proposed for use in assessing ethanol intake and in monitoring compliance with therapeutic regimens. Exploration of a theoretical basis for use of CTDC in these circumstances and for its use in assessing other aspects of drug disposition kinetics was undertaken. Effects of single and multicompartmental drug disposition models, single dose and multiple dose regimens, with regular and irregular doses and dosing intervals, and zero-order, first-order, and Michaelis-Menten excretion patterns were explored. First-order transepidermal drug transfer was assumed with and without back transfer from the collection device. These analyses suggest that the utility of CTDC is severely restricted when back transfer from the collection device is substantial. With back transfer minimized, CTDC may be a useful tool for assessing amount of drug exposure, compliance with therapeutic regimens, and relative bioavailability, but offers little advantage over discrete sampling of other body fluids in the study of other aspects of drug disposition kinetics.The views of the authors do not purport to reflect the positions of the Department of the Army or the Department of Defense. (Para. 4-3, AR 360-5).     

Assessment of the risk-benefit ratio for antiarrhythmic drug use

Arrhythmia treatment has always been difficult, particularly as there are no good indicators of the optimal management strategy. The introduction of new antiarrhythmic agents has forced reappraisal of how these drugs are used. Dynamic electrocardiography and invasive electrophysiological studies are important tools for classifying and characterizing arrhythmias and for assessing the efficacy of therapy. There is still an enormous gulf between present day treatment and a scientific basis for drug selection, but risk-benefit analysis is possible, at least for patient populations and for some specific arrhythmias. Individual risk-benefit analysis, much needed by clinicians, is still a long way from reality. This article examines the concept of risk-benefit analysis and indicates those areas where progress can be made.     

血站采供血过程中医源性感染的预防与控制

本文笔者从血站采供血关键控制点中存在的医源性感染进行分析,认为通过加强血站采供血过程管理、健全管理制度、重视员工培训和管理、建立健康档案、购置防护设备、加强环境消毒及医疗废物的消毒处理等措施,可以有效预防血站医源性感染事件的发生。