4600例拟输血患者输血前4项传染病指标检测结果分析

目的：了解拟输血患者输血前传染病感染状况,减少因输血引起的医疗纠纷并探讨有关检查项目设置的必要性。方法：对4600例拟输血患者采用酶联免疫吸附试验（ELISA）检测其血清中乙型肝炎病毒表面抗原（HBsAg）、丙型肝炎病毒抗体（抗-HCV）、人类免疫缺陷病毒抗体（抗-HIV）、梅毒螺旋体抗体（抗-TP）4项常见传染病指标。结果：在4600例患者中,HBsAg阳性348例（7．57％）、抗-HCV阳性116例（2．52％）、抗-HIV阳性（经省CDC确诊）1例（O．0002％）、TP阳性77例（1．67％）。检测阳性总数为542例,总阳性率为11．78％。结论：对受血者进行输血前检测,可以减少医院感染,降低职业暴露的危险,加强医护人员的自我保护,减少因输血引起的医疗纠纷。     

台州地区2072例患者输血前4项感染性指标检测情况分析

目的:了解台州地区拟输血患者经输血传播疾病的感染状况,减少输血医疗纠纷,保证临床输血的安全。方法:用ELISA法检测2 072例准备输血患者的HBsAg(定性),抗HCV抗体,TPPA抗体和HIV抗体4项感染性指标。结果:2 072例患者中,HBsAg阳性率8.16%,抗HCV阳性率0.63%,TPPA阳性率1.16%,抗HIV阳性率0.14%。结论:通过输血前感染指标检测,明确患者的感染情况,保护医患双方的利益,避免输血引起的医患纠纷。     

储存式自体输血在Rh(D)阴性血型患者择期手术中的应用

目的:探讨储存式自体输血在Rh(D)阴性血型患者择期手术中的应用.方法:对78例Rh(D)阴性血型患者在术前3～9 d根据预计术中输血量分次采集自体血800～1200 ml.采血后患者口服多糖铁150 mg,tid同时适当加强营养.采集的血液置4℃贮血冰箱内保存备用.结果:78例患者中除4例因肿瘤巨大手术出血量过多,分别输异体悬浮红细胞3 U(2例),4 U(2例),其余病例均未输注异体血,手术获得顺利完成.检测患者采血前,后及回输后Hb、Hct值,经统计分析差异无统计学意义.结论:储存式自体输血对Rh(D)阴性血型患者在择期手术中是解决血源紧张的一种行之有效的方法,具有临床推广应用价值.     

Successful treatment of severe Raynaud's phenomenon with bosentan in four patients with systemic sclerosis

SIR, Systemic sclerosis (SSc) is an autoimmune disease thatmainly affects the skin and internal organs, such as the gastrointestinaltract, lungs, kidneys and heart [1]. One of the key clinicalfeatures is Raynaud's phenomenon (RP), including important painand digital ulceration that often results in functional disability.Therapeutic management of severe RP is usually a clinical challenge,with intravenous infusions of prostaglandin analogues usuallybeing effective, but necessarily invasive. Bosentan is an oral antagonist of endothelin [2], a potent endogenousvasoconstrictor implicated in the aetiopathogenesis     

Transverse colon diverticulitis: Successful nonoperative management in four patients

PURPOSE: Diverticulitis of the transverse colon is a rare disorder and is often confused with other conditions. Previously reported cases of transverse colon diverticulitis were diagnosed and treated by surgical exploration. Four cases are presented that were successfully managed with a nonsurgical approach. METHODS AND RESULTS: Review of the literature in English disclosed 31 cases of transverse colon diverticulitis. The clinical characteristics and management of these patients are reviewed and compared with the current series of patients. The utility of computerized tomography in the diagnosis of diverticulitis is discussed. CONCLUSIONS: Medical therapy with bowel rest and antibiotics is appropriate for transverse colon diverticulitis when free perforation and peritoneal signs are absent and the inflammation is contained, as shown by computerized tomography. Operative exploration should be reserved for patients with diffuse peritonitis or those where perforated colon cancer cannot be excluded.     

76例输血患者临床输血不良反应情况调查

目的:了解输血患者临床输血不良反应发生情况,为制定预防措施提供理论依据。方法:对2007-01-2013-06各种血液制品输注患者发生输血不良反应病例进行统计分析。结果:①在4 559例输血患者中发生不良反应76例,不良反应发生率为1.67%,其中发生发热反应31例,占40.79%,发生过敏反应45例,占59.21%,没有发生溶血性输血反应。②在各种血液制品中,以冰冻血浆不良反应发生率最高,为3.83%,以滤白细胞悬浮红细胞不良反应发生率最低,为0.72%。各种血液制品不良反应发生率比较,差异有统计学意义(χ2=31.71,P0.01)。③输血不良反应发生率随输血次数的增加而升高(χ2=22.16,P0.01)。结论:提高对血液制品的认识、严格掌握输血适应证以及应用滤除白细胞的技术等是降低输血不良反应发生率、提高输血安全性的重要措施。     

The problems of indeterminate HIV results in blood transfusion services in Nigeria

Five hundred sera samples were collected from individuals whose age range was 16-40 years, analysed using Murex 1 and 2 and Capillus HIV kit (Cambridge Biotechnology, Cambridge, UK), and confirmed with Western Blot technique (Biorad). Of these, 186 (37.2%) were repeatedly reactive, 90 (48.4%) were confirmed positive, 55 (29.6%) indeterminate (20 [10.7%] from blood donors) and 44 (22.0%) were negative. The data reveal a significant correlation between indeterminate results and confirmed positive sera (P < 0.05). This demonstrates the high incidence of indeterminate HIV results encountered in blood transfusion services.     

Benefits and complications of regular blood transfusion in patients with beta-thalassaemia major

Early and regular blood transfusion therapy in patients with homozygous beta-thalassaemia decreases the complications of severe anaemia and prolongs survival. In the long term, however, the beneficial effects of transfusions are limited by the organ damage resulting from iron overload, a consequence of the body's limited capacity to excrete iron, and by the complications of infection with blood-borne agents. Transfusion regimens for beta-thalassaemia have changed substantially during the past four decades. In current protocols, pre-transfusion haemoglobin concentration should not exceed 95 g/l. This allows adequate control of anaemia, with a relatively low rate of iron accumulation. Although iron chelation therapy has successfully improved survival free from cardiac disease, thalassaemic patients continuously present new clinical challenges. In fact, the vast majority of them suffer from post-transfusion chronic hepatitis C, which is expected to significantly contribute to morbidity in the forthcoming years. Furthermore, recent studies demonstrated that thalassaemics are at high risk of acquiring several blood-borne viruses. The potential role of these multiple infections in inducing clinical disease is still uncertain, and needs to be thoroughly clarified in future surveys.     

损伤性血胸自体血回输12例临床应用分析

目的探讨损伤性血胸自体血回输的应用效果。方法将12例损伤性血胸患者,采用胸腔闭式引流装置回收血胸血,并进行自体回输。结果血胸自体血回输过程无严重不良反应,患者全部治愈。结论血胸自体血回输是一种安全、有效的治疗手段,对急诊外伤患者尤为适用。