护理干预对初次机采血小板献血者再次献血的影响

机采血小板因浓度高、纯度高、红细胞和白细胞污染少,受血者输注后不易产生HLA抗体和血小板抗体,有效提高了输注血小板效果,并能迅速提高受血者血小板计数等,被临床广泛使用。但其特殊的采集方式和对捐献者的高要求,使机采血小板捐献者的征召与保留成为困扰血液工作者的一个难题。如何调动献血者积极性,     

初次全血献血者再次献血影响因素研究

目的研究影响初次全血献血者再次献血的影响因素。方法以2016年1月～2016年12月首次在广州血液中心参加无偿献全血且接受了电话回访的初次献血者66976名,完全随机抽样法抽取2214名献血者,自中心采供血信息管理系统调取相关社会学信息,献血者服务中心对首次献血者的电话回访记录调取回访信息。卡方检验筛选出的对初次全血献血者再次献血的影响有统计学意义的因素,纳入运用多因素Logistic回归分析法进一步分析。结果 2214名初次献血者中,卡方检验显示对初次全血献血者是否再次献血有统计学差异的因素是性别、献血类型、献血量和有无献血反应。纳入多因素logistic回归分析后显示,无献血反应(OR=1.753,OR95%CI:1.100～2.794,P=0.018)的初次献血者再次献血可能性较大,男性(OR=0.681,OR95%CI:0.539～0.859,P=0.01),街头献血者(OR=0.641OR95%CI:0.509～0.808,P 0.001)和200 mL献血量(OR=0.641 OR95%CI:0.509～0.808,P 0.001)的初次献血者再次献血意愿的可能性减少,差异有统计学意义。结论是否有献血反应、献血量、性别及献血类型是首次献血献血者再次献血的影响因素。有献血反应,献血量200mL,男性,街头的初次献血者更容易流失。     

机采血小板对献血者的影响及护理

随着器官移植、抗肿瘤治疗的广泛开展，发生血小板减少的患者日益增多，血小板输注的需求也逐步增多，血小板质量的好环直接与疗效有关。而机采血小板具有浓度高、纯度高、白细胞和红细胞污染率低、无需大量献血者，使患者输注后不易产生HLA抗体和血小板特异性抗体，从而显著降低输注血小板无效率，快速提高患者血小板计数。因此机采血小板输注成为现代输血的重要内容。     

如何降低机采血小板献血者献血不良反应的发生

机采血小板的采集过程因为采集时间长、处理血量大以及抗凝的血液回输等原因,所以献血不良反应发生率较全血高,最常见的是枸橼酸钠中毒反应。本文分别从献血的前中后分析发生的原因及其应采取的有效措施,同时需要更多关注女性献血者和初次献血者。献血全程有效的心理护理和观察,才能有效降低献血不良反应的发生。     

探讨一种新的护理模式对初次机采血小板献血者的影响

目的探讨一种新的护理模式即全程护理结合中医望诊在初次机采血小板献血者献血中的应用效果。方法选择2016年1~12月初次来我站参加捐献血小板的献血者198人,随机分为观察组(采用一对一全程护理结合中医望诊)和对照组(采用一对多日常护理),观察两组体检合格率、献血反应发生率、捐献成功率、二次以上召回率的情况。结果两组之间体检合格率比较,差异有统计学意义(χ~2=4.138,P=0.042);165名体检合格献血者参加献血的两组之间献血反应率、捐献成功率、二次以上召回率比较,差异均有统计学意义(χ~2=4.623、5.582、33.075,P分别为0.032、0.018、0.001)。结论全程护理结合中医望诊对初次机采血小板献血者实施了一对一全程人性化的护理,在征询、体检、初筛、采集等过程运用中医望诊加强观察,弥补了日常护理的不足,能严格筛选献血者,减少献血反应的发生,提高捐献成功率和二次以上献血者召回率,对保证献血者安全及提高血液的产品质量,建立一支固定的献血者队伍有着十分重要的意义。     

320人次机采血小板献血者观察

机采血小板是目前我国逐渐推广的一种血小板采集技术。由于机采血小板具有纯度和浓度高，红细胞、白细胞污染少，受血者产生ＨＬＡ抗体和血小板抗体的机会减少等优点，为临床所接受。笔者对３２０人次献血者在采集血小板过程中的反应进行了观察，现将观察结果报告如下。１...     

机采血小板后献血者血小板恢复情况探讨

目的　探讨 Amicus血细胞分离机采集单剂量、双剂量血小板对健康献血者血小板计数的影响。方法　应用Amicus血细胞分离机在 2 .5版本操作软件的支持下采集血小板。单剂量组 2 2例 ,设定采集量 3 .0× 1 0 1 1 /L,双剂量组 3 1例 ,设定采集量 6.0× 1 0 1 1 /L。分别观察献血者采前、采后及采集 1个月后献血者的血小板计数值。结果　单剂量组、双剂量组采集血小板量分别为 ( 2 .86± 2 .3 9)× 1 0 1 1 /L、( 5 .75± 4.46)× 1 0 1 1 /L。单剂量组采集前血小板量 [( 2 1 1 .64± 2 1 .2 7)× 1 0 9/L ]显著高于采集后 [( 1 3 5 .73± 2 0 .94)× 1 0 9/L]( P<0 .0 5 ) ;双剂量组采集前血小板量 [( 2 70 .2 6± 3 7.2 5 )× 1 0 9/L ]亦显著高于采集后 [( 1 41 .3 9± 3 9.2 8)× 1 0 9/L]( P<0 .0 5 )。单剂量组、双剂量组的献血者血小板计数较采集前分别下降 3 5 .0 %±1 2 .6%、47.9%± 1 5 .9%。采后 1个月单剂量组献血者血小板回升为 ( 2 1 5 .86± 2 4.5 6)× 1 0 9/L,而双剂量组回升为 [( 2 60 .3 2±3 8.71 )× 1 0 9/L],与采前比较差异有显著性 ( P<0 .0 5 )。　结论　单剂量组机采血小板对献血者健康和血小板制品质量无不良影响。建议双剂量组应提高献血者采前血小板底限值 ( >2 5 0× 1 0 9/L     

机采血小板献血者献血小板间隔时间的探讨

机采血小板献血者献血小板间隔时间的探讨１０００８８北京市红十字血液中心高东英许秀兰王春荣杨海平王振平赵海燕９０年代，机采血小板在我国临床上迅速推广，并取得了良好的疗效，但目前，卫生部尚未颁布机采血小板献血者的标准。为此，本中心质控科对献血者机采血小板...     

红细胞污染机采血小板的献血者因素分析

目的找出红细胞污染机采血小板的献血者因素,从而在挑选献血员中考虑这些因素,以提高血小板质量和外观,减少输血反应,减免交叉配血过程。方法对2003年至2005年三年间出现的红细胞污染机采血小板进行分析,排除机器故障、操作失误及脂血等原因,就献血员自身因素进行回顾性研究。结果发生红细胞污染的献血者在血小板体积分布宽度方面与正常献血者有显著性差异。结论红细胞污染机采血小板与献血员的血小板体积分布宽度偏大有关。     

浅谈机采血小板献血者的心理护理

随着器官移植、抗肿瘤治疗的广泛开展，血小板减少的患者日益增多，血小板输注的需求也逐步增多。因此，机采血小板输注成为现代输血的重要内容。无偿捐献机采血小板是无偿献血的重要组成部分。为了进一步推动无偿献血工作的发展，建立一支稳定的无偿机采血小板献血者队伍，保证临床用血需求和献血者的安全，笔者结合工作实践，谈谈个人的体会。     

How regular blood donors explain their behavior

BACKGROUND: To understand repeated donation, it is crucial to know its meaning. This issue was explored by asking a sample of regular donors to explain why they maintain this behavior. STUDY DESIGN AND METHODS: Discourse analysis was conducted in five groups of regular donors, selected according to the setting and number of their donations (from 1990 to 2001), on their motivation, attitudes, commitment to donation, personality, and self-concept. RESULTS: Three discursive positions were distinguished in relation to the different cultural meanings attributed to blood donation. Blood donation was understood in a rational and evaluative manner by the majority but in an emotional, personalized, and stereotyped manner by a minority. Continual donation as a form of help was rationalized as a function of internal and external factors, notably personal convenience in comparison to other helping behaviors and ease of access to collection points. CONCLUSIONS: The discourse referents offered to the donor greatly influence the meanings they attribute to their behavior. Some promotional materials should be revised because they may not connect with the reasons for donating that people find most comprehensible.     

Risk factors for HIV seropositivity among first-time blood donors in Zimbabwe

BACKGROUND: Factors associated with an increased likelihood of HIV infection among newly recruited blood donors in Zimbabwe are identified. Their feasibility as criteria for exclusion from donation is assessed. STUDY DESIGN AND METHODS: A self-administered survey including demographic and behavioral questions was completed by 1199 first-time, volunteer blood donors in Harare, Zimbabwe. Methods for subject recruitment and laboratory screening followed usual blood bank protocols. RESULTS: Fifteen percent of subjects were HIV positive. Factors significantly associated with HIV seropositivity at the p<0.05 level included recruitment venue, age, marital status, donor residence, residence of primary partner, occupation, history of sexually transmitted disease, and condom use. An exclusion strategy based on donor age, condom use, recruitment venue, sexually transmitted disease history, and residence of primary partner would exclude a large proportion of HIV-infected donors without substantial loss of uninfected donors. CONCLUSIONS: Exclusion of donors who are likely to be infected with HIV is a sound policy for improving blood safety and reducing operating costs worldwide. Identification of efficient donor selection criteria requires knowledge of the local epidemiology of HIV infection and the asking of questions that are likely to be answered accurately.     

首次复治肺结核患者疗效影响因素分析

目的了解影响首次复治肺结核患者疗效的因素。方法回顾性分析2002年1月-2004年12月上海市疾病预防和控制中心登记痰结核菌阳性（涂片阳性或培养阳性）的283例首次复治肺结核患者资料。对可能影响疗效的各种因素进行单因素和多因素分析。结果首次复治肺结核患者的总治愈率为74．9％。单因素分析有肺结核空洞、初治确诊延迟、初治用药数量、耐药性、不同复治类型和复治方案等6个因素与复治疗效有关。多因素分析显示：耐药性、不同复治类型和复治方案为影响首次复治肺结核患者疗效的主要因素。结论耐药、不同复治类型、复治方案是影响首次复治肺结核患者疗效的重要因素。     

定期无偿献血者NK细胞免疫功能的研究

目的 分析定期无偿全血捐献者、血小板捐献者的NK细胞数量以及细胞毒活性,评价定期捐血对机体NK细胞免疫功能的影响.方法 采用流式细胞术对三组人群(定期无偿全血、血小板和首次捐血者,后者为对照组)外周血中NK细胞群的数量进行分析.采用效/靶细胞混合培养的方法,计算出NK细胞对靶细胞的杀伤率.结果 全血捐献者NK细胞数量及其对靶细胞的杀伤率与对照组的差异无统计学意义(P>0.05);血小板捐献者NK细胞数量较对照组明显增高(P<0.05),而NK细胞杀伤活性明显降低(P<0.05).结论 本研究结果说明,全血捐献者献血间隔期较长(>3个月),机体有足够的时间来恢复NK细胞数量及其细胞毒性,而血小板捐献者献血间隔期短,机体通过NK细胞数量的增加来调节由于其功能降低对机体造成的影响.     

Apheresis donors and platelet function: inherent platelet responsiveness influences platelet quality

BACKGROUND: Process-induced platelet (PLT) activation occurs with all production methods, including apheresis. Recent studies have highlighted the range and consistence of interindividual variation in the PLT response, but little is known about the contribution of a donors' inherent PLT responsiveness to the activation state of the apheresis PLTs or the effect of frequent apheresis on donors' PLTs. STUDY DESIGN AND METHODS: The relationship between the donors' PLT response on the apheresis PLTs was studied in 47 individuals selected as having PLTs with inherently low, intermediate, or high responsiveness. Whole-blood flow cytometry was used to measure PLT activation (levels of bound fibrinogen) before donation and in the apheresis PLTs. The effects of regular apheresis on the activation status of donors' PLTs were studied by comparing the in vivo activation status of PLTs from apheresis (n = 349) and whole-blood donors (n = 157), before donation. The effect of apheresis per se on PLT activation was measured in 10 apheresis donors before and after donation. RESULTS: The level of PLT activation in the apheresis packs was generally higher than in the donor, and the most activated PLTs were from high-responder donors. There was no significant difference in PLT activation before donation between the apheresis and whole-blood donors (p = 0.697), and there was no consistent evidence of activation in the donors immediately after apheresis. CONCLUSION: The most activated apheresis PLTs were obtained from donors with more responsive PLTs. Regular apheresis, however, does not lead to PLT activation in the donors.     

比浊法血小板聚集试验的影响因素研究

目的 在不同的实验条件下,观察影响比浊法血小板聚集试验的因素.方法 选择30例健康对照组和204例病例组,观察不同的血小板计数及诱导剂浓度对糖尿病患者餐前与餐后、采血后的检测时间、诱导剂的种类互补等不同试验条件下的血小板聚集率.结果 随着血小板计数的减少或增加,血小板聚集率相应的减少或增加;二磷酸腺苷(ADP)、胶原(COL)、花生四烯酸(AA)浓度增加,血小板最大聚集率增大,相应的阿司匹林抵抗(AR)或氯吡格雷抵抗(CR)的检出率增高;服用不同的抗血小板药物,糖尿病患者对以ADP、COL、AA为诱导剂测定的血小板聚集率,其影响不同;未空腹及检测时间超过3 h重复性较差;服药2周后,COL、AA诱导的血小板聚集率下降不明的患者,随着时间的延长,6个月后易重新出现CR.结论 血小板计数、诱导剂浓度、糖尿病疾病、空腹状态、检测时间与比浊法检测血小板聚集率相关,以ADP、COL、AA作诱导剂检测血小板聚集率较单一的ADP更全面、准确.