引起献血不良反应的原因分析与预防措施

自开展无偿献血以来,在日常采血过程中,发现了由各种原因引起的个别献血者在献血过程中或献血后发生的一些献血不良反应,不仅给献血者增加了心理负担,同时也影响了他们再次献血的勇气和热情,为了提高固定无偿献血者队伍的比例,减少献血者不良反应的发生,现对献血不良反应发生的因素及预防措施进行分析如下.     

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。     

单采血小板献血者血肿情况分析

目的:分析单采血小板献血者血肿情况和发生原因,探讨血肿改进措施和电话再招募方式,以促进献血者的保留。方法:通过血液管理信息系统和现场登记的献血不良反应记录单,统计分析2017年福建省血液中心单采血小板血肿相关数据,对血肿发生后大于3个月未再次捐献单采血小板的献血者按照招募程序逐一电话再招募。结果:8 835例单采血小板献血者中,发生血肿257例(2.91%),男性初次献血者(16例)与男性重复献血者(173例)血肿比较差异有统计学意义(P0.05)。在献血者血肿后未再次捐献的比较中:男性初次献血者(15例)与男性重复献血者(36例)比较;女性初次献血者(9例)与女性重复献血者(26例)比较;男性重复献血者(36例)与女性重复献血者(26例)比较,3组均差异有统计学意义(均P0.01)。257例血肿主要原因按比例依次是采血人员采血技术欠佳113例(43.97%)、献血者血管条件欠佳57例(22.18%)、捐献过程手臂移动56例(21.79%);单采血小板血肿后未再次捐献的献血者电话再招募成功率为55.81%(48/86)。结论:单采血小板血肿发生后对初次献血者和女性献血者献血意愿影响较大。针对血肿原因,提高工作人员穿刺技术,捐献过程中人性化的服务可减少血肿的发生。对单采血小板血肿后未再次捐献的献血者进行电话再招募,简便、易行、成功率高,有助于献血者的回召和保留。     

流动采血车实施整体护理的体会

我国已实施无偿献血，流动采血车已成为血站流动采血的主要场所，但因采血车内操作场地小、条件简陋、时间紧、人员少等因素影响，如何增强人们的献血意识，减少献血不良反应，使不同层次的献血者都得到满意的护理显得尤为重要。笔者于2005—03—14／2005—12—30对流动采血车上符合各项献血标准的献血者1例，对其进行有针对性的、系统的整体护理，明显减少了献血不良反应，取得满意效果，现报告如下。     

浅谈献血不良反应预防为主的重要性

目的本文则针对献血者献血后出现不良反应的进行处理方法和经验的总结,减少及预防献血时不良反应的发生率,望医务工作者相互交流。方法根据多年的临床经验及献血体检工作,记录和收集献血过程中出现的不良反应,进行整理、总结。结果通过多重手段对献血前及献血后进行预防、干涉,明显使献血不良反应的发生率降低。结论心理辅导和血液的理化认知是献血前必须了解的,通过这种方式,才能减少献血过程中不良反应的发生率。     

成分献血不良反应的预防及处理

目的：探讨引起成分献血者发生不良反应的因素,制订出相应的预防及处理措施,减少不良反应的发生,保证献血者的安全和血液成分产品的质量,促进无偿成分献血者的招募和保留。方法：分析献血不良反应发生的原因,实施不良反应的预防及处理措施,对无偿成分献血者的献血全过程精心护理。结果：献血不良反应的发生与性别、献血次数等因素密切相关,献血不良反应中低钙反应发生率最高。通过采取相应的预防及处理措施,使无偿成分献血者轻松、愉快的完成献血过程,成为固定的无偿成分献血者。结论：针对不同的原因采取相应的预防及处理措施,可大大减少献血不良反应的发生,保证献血者的安全和血液成分产品的质量,促进无偿成分献血者队伍的稳定、壮大。     

人性化护理在糖尿病患者静脉采血中的应用效果

目的探讨人性化护理在糖尿病患者静脉采血中的效果。方法选取2017年7月—2018年7月在该院进行静脉采血的糖尿病患者226例,随机分为2组,各113例,观察组给予人性化护理,对照组给予常规护理。结果观察组不良反应发生率为9.7%,患者满意度为96.4%,对照组不良反应发生率为24.8%,患者满意度为82.3%,两组比较差异有统计学意义(P0.05)。结论糖尿病患者静脉采血过程中实施人性化护理,可有效减少不良反应发生,提高患者满意度。     

采血护士在降低献血反应中的作用

我们工作中发现,在采血环境、体检和化验医生相同的情况下,接受不同的采血护士操作的献血者献血反应发生率是不同的.     

献血后静脉穿刺部位皮下瘀血的原因及护理对策

近年来 ,我们对献血后静脉穿刺部位出现皮下瘀血的原因进行了分析并探讨相关护理干预措施 ,能最大限度地保护献血者的身心健康 ,减少或避免无偿献血工作的负面影响。临床资料 :2 0 0 3年本市参加无偿献血者 14 817人 ,年龄18～ 5 5岁 ,献血后出现静脉穿刺部位皮下瘀血 10 8人 ,其中初次献血者 82人 ,再次献血者 2 6人 ,初次献血者明显多于再次献血者 (P<0 .0 5 )。皮下瘀血的原因包括 :按压位置不当 (32例 )、穿刺不顺利 (16例 )、按压时间短 (2 1例 )、屈肘止血 (18例 )、袖口紧 (16例 )、晕针 (5例 )。护理干预对策 :1采血者要加强工作责…     

浅析外周动脉采血在新生儿护理中的应用

目的探究外周动脉采血在新生儿护理中的应用效果。方法选取我院收治的104例新生儿,将其随机分成观察组和对照组各52例。观察组通过外周动脉的方式进行采血,对照组给予股静脉穿刺的方式进行采血,对比两组新生儿采血过程的成功率和不良反应情况。结果观察组采血成功率为90.38%,对照组采血成功率为86.53%,两组采取成功率比较,差异不大,经统计学分析,差异无统计学意义(P0.05);观察组不良反应发生率为5.77%,由于对照组不良反应发生率26.92%,差异显著,经统计学分析,差异具有统计学的意义(P0.05)。结论新生儿护理中采取外周动脉采血,与股静脉穿刺采血方式比较,两者的成功率差别不大,均具有较高的成功率,但采取外周动脉采血方式可有效降低新生儿采血中不良反应情况发生率,值得临床推广应用。     

Blood Transfusion or Blood Substitution?

Blood transfusion has become a universally accepted, life-saving procedure in modern clinical medicine. In addition, specific blood fractions are widely used in the therapeutic treatment of haematological disorders. Problems are, however, encountered in conventional transfusion practice and in the clinical use of blood components. This paper outlines some of those problems and considers how plasma expanders and oxygen-carrying blood substitutes may be used to overcome some of them. The extent to which acceptable blood substitutes have been developed and tested in both animal and human studies is especially emphasized.     

Laboratory Proficiency in Blood Banking: The Variability of Blood Bank Reagents for Blood Typing

Abstract. A statistical analysis of the 1970 College of American Pathologists Comprehensive Blood Bank Survey was made to determine if variability of blood bank reagents may affect the testing of laboratory proficiency in blood banking. Antisera marketed by 5 manufacturers were used sufficiently widely for satisfactory statistical comparisons. Discordant results were noted among manufacturers of sera used to detect A₁-positive, A-positive, rh' (C)-positive, rh' (C)-negative, hr' (c)-positive and hr'(e)-positive. This indicates an undesirable variability of some batches of blood bank reagents.     

人体测量指标与血脂、血糖及血压水平的典型相关

目的：探讨人体测量指标与心血管危险因素水平的相互关系，确定与心血管危险因素相关最密切的人体测量指标。方法：在江苏省金坛县农村抽取３５～５９岁自然人群（男４９２名；女６０６名），测量身高、体重、腰围、腹围、臀围和血胆固醇、高密度脂蛋白胆固醇、血糖、收缩压、舒张压，计算出体重指数（ＢＭＩ）、腰／臀比（ＷＨＲ）、腹／臀比（ＡＨＲ）和锥削度指数（ＣＩ）后，与血脂、血糖及血压水平作典型相关分析。结果：人体测量指标与心血管危险因素指标呈典型相关（典型相关系数为０．３１～０．５０）；人体测量指标中，体重指数的贡献最大，与心血管危险因素的相关最密切；血压是心血管危险因素中与人体测量相关最密切的指标。结论：体重指数是本组人群中最简单但最有价值的人体测量指标；而血压是受肥胖影响最大的心血管危险因素指标。     

Alternatives to Human Blood and Blood Resources

Biotechnology is increasingly providing alternatives to established transfusion products, with the promise of freedom from infectivity and unlimited supply. Such products must demonstrate a safety and efficacy at least as great as current products, and thereafter an improved cost-benefit ratio. Alternatives to established products may be categorised as:

• ? Alternatives made from blood donations.
• ? Substitutes (acting by distinct mechanisms).
• ? Recombinant analogs.
• ? Cellular therapies (including gene therapy).

This overview covers the current status in each of these categories, and likely trends in the near future. Recombinant therapeutic proteins are already established in certain indications, and are likely to be extended to a wider range of applications as the methods for bulk production are improved. Alternative products from donated blood should find niche indications, especially for acute therapy, but cellular therapy is unlikely to be widely implemented on this timescale, except as an adjunct in life-threatening indications. Substitutes are perhaps the most interesting category and are expected to have a major impact, particularly through the use of “poietins” to stimulate endogenous production of circulating cell populations.     

Blood Distribution Systems and the Exchange of Information between Hospital Blood Banks and Regional Blood Centers

Abstract. The advantages and disadvantages of centralized or decentralized reactive or predictive blood distribution systems are presented. A decentralized, predictive distribution system, being used by the Long Island Blood Services Division of the Greater New York Blood Program is described and its applicability to most regional blood supply organizations is emphasized.     

Blood Group-Active Surface Molecules of the Human Red Blood Cell

The surface of the human red blood cell is dominated by a small number of abundant blood group active proteins. The major proteins are the anion transport protein (band 3) which has AB(H) activity, and Glycophorin A which has MN activity. Band 3 and Glycophorin A are of equal abundance in the normal red cell membrane (approximately 10(6) copies of each) and the two proteins may associate together as a complex. The glucose transporter (band 4.5) had AB(H) activity and there are about 5 x 10(5) copies/red cell. Several polypeptides associate together to form the Rh complex. The major components of this complex (abundance 1-2 x 10(5) copies/red cell) are polypeptides of Mr 30,000, polypeptides of Mr 45,000-100,000 and Glycophorin B. The antigens of the Rh blood group system appear to be associated with the polypeptides of Mr 30,000 and those of Mr 45,000-100,000 (the latter also express AB(H) activity). Glycophorin B expresses the blood group 'N' antigen and the Ss antigens. Glycophorins C and D carry the Gerbich antigens and, together, these polypeptides comprise approximately 10(5) copies/red cell. The complete protein sequence of all the above-mentioned proteins is known, except for the Mr 30,000 and Mr 45,000-100,000 polypeptides of the Rh complex for which only partial sequences are available, and Glycophorin D, the sequence of which can be inferred from that of Glycophorin C. Several of the minor blood group active proteins at the red cell surface (abundance less than 1.2 x 10(4)/red cell) have been the subject of recent studies. The polypeptide expressing Cromer-related blood group antigens has been identified as decay-accelerating factor and that carrying the Ina/Inb antigens as CD44. The protein sequence of both of these proteins has been deduced form nucleotide sequencing. The polypeptides expressing Kell antigens, Lutheran antigens, Fy antigens, and LW antigens have also been identified and partially characterised.     

Adenine-Supplemented Blood

IgG in factor VIII preparations was studied as a possible cause of adverse reactions following infusion of hemophiliacs. Thin-layer immuno-gel filtration analysis of nine products from seven firms demonstrated aggregated and monomeric IgG at highly variable amounts and proportions. These factor VIII products contained from 20 to 700 mg IgG per 1000 IU of factor VIII; IgG-fibrinogen complexes were demonstrated by double-antibody testing. A relationship is suggested between aggregated IgG and/or IgG complexes in factor VIII concentrates and adverse clinical reactions. They may also partially explain abnormalities and aberrations of the immune system previously reported in hemophiliacs.     

Blood Kallikrein

Three chief components of the kallikrein-kinin system (kallikrein, kininogen, kininase) were studied in the blood of 42 patients with acute pancreatitis. Significant increase in content of kallikrein, decrease in level of kininogen, and increase of kininase activity were observed. The highest values for kallikrein, kininogen and kininase activity were found in patients in whom acute pancreatitis was accompanied by hemodynamic changes.