梧州市血液检测阳性无偿献血者的分布情况

目的：了解梧州市血液检测阳性的无偿献血者的分布情况。方法对梧州市2010～2012年108879例无偿献血者的丙氨酸氨基转移酶（ALT）、乙肝表面抗原（HBsAg）、丙型肝炎病毒抗体（抗‐HCV）、人类免疫缺陷病毒抗体（抗‐HIV）、梅毒抗体（抗‐TP）检测结果进行回顾性统计分析。结果108879例无偿献血者中,5项检测指标的总阳性率为6．01％（6548/108879）,其中ALT阳性率为4．86％、HBsAg阳性率为0．57％、抗‐HCV阳性率为0．20％、抗‐HIV阳性率为0．07％、抗‐TP阳性率为0．59％。男性和女性之间ALT、HBsAg和抗‐HCV阳性率差异有统计学意义（P＜0．05）。ALT、抗‐TP阳性率最高的年龄组均为18～30岁,抗‐HCV阳性率最高的是大于30～40岁组。结论加大无偿献血宣传力度,做好献血前咨询,选择低危献血人群,对保证血液质量,减少输血传播疾病有重要意义。     

Safe transfusion of blood and blood components

Nurses are integral to the blood transfusion process. This article, which forms part of Nursing Standards clinical skills series, outlines the role of the nurse in evidence-based transfusion practice. Patient assessment, preparation, pre-transfusion checks, documentation and adverse reactions are discussed.     

Current viral risks of blood and blood products

A number of viruses may be transmitted by blood transfusion, the most important of these are HIV, human T-cell lymphotrophic retrovirus (HTLV), hepatitis B virus (HBV), and hepatitis C virus (HCV). A series of overlapping safety measures are in place and are being improved and supplemented continuously. As a result, the risk of transmission of these viruses in the USA has been reduced to between one and four per million blood components transfused.     

血型卡在血型鉴定中的局限性

ABO血型系统的抗原除经典的A、B、O外，还有许多抗原性较弱的亚型和变异型，如A2、A3、Ax、Aend、AM等,相对应的B亚型有B3、Bx、Bm,B（A）、Bel等。西方人的B亚型少于A亚型，而我国则为B亚型频率高于A亚型，AM、AX更是极少见。ABO血型鉴定的方法主要有血型卡法、试管法、玻片法、微量板法等，血型卡以其简便、易判读、便于大量标本分析而被广泛应用。但血型卡在ABO亚型的鉴别时却有一定的局限性，有的结果可造成漏检。而正确鉴定红细胞血型是确保输血安全的先决条件，在临床输血及采供血机构工作中．对ABO血型系统中的亚型鉴定主要还是依据血清学方法。     

Effect of blood donation on well-being of blood donors

The demand for blood products steadily increases. Concurrently, blood donor recruitment becomes more and more difficult. This study aimed to investigate effects of blood donation on blood donors, which could be helpful for blood donor recruitment and retention. In addition to cortisol measurements in saliva, three questionnaires quantifying mood (good/bad), vigilance (awake/tired), agitation (calm/nervous), actual strain and asking for donation-related effects perceived were distributed to 110 whole blood donors (DON). Results obtained were compared with 109 control subjects (CON) lacking the blood donation experience. Overall, 216 subjects completed the questionnaires. Sixty-eight percent of DON reported at least one effect perceived with blood donation. Exclusively, positive, negative or mixed effects were described by 26.5%, 23.5% and 17.6%, respectively. Among positive effects (i.e. physical/psychological well-being, feeling satisfied, happy, proud), no significant differences were observed between males and females (P = 0.07), whereas mixed or negative effects (i.e. vertigo, dizziness, tiredness, pain) were significantly (P = 0.03; P = 0.049) more associated with females. DON showed higher levels of well-being than CON as indicated by better mood (P = 0.004), higher vigilance (P = 0.015) and relaxation (P = 0.003). The latter even increased after donation with maximum values after 15 and 30 min. Despite significantly higher initial strain scores (P = 0.008), first-time donors maintained a better mood (P = 0.025) than repeat donors. DON showed a statistically better psychological well-being than CON, although the donation experience was perceived as stressful, especially for first-time donors. The results may facilitate donor recruitment and retention as blood donation may become less frightening and perhaps even attractive.     

血液净化血管通路的护理进展

血管通路的发展伴随着血液净化技术的进步,经历了一个相当漫长的时期,随着血液净化技术的不断进步和提高,移植血管内瘘和高分子合成材料制成的人造血管内瘘被使用,护士是维护血管通路的第一使者,护士细致的观察和规范的护理,能减少和预防并发症的发生.但患者身体条件,医疗器材及护理操作是护理血管通路研究的方向.     

新生儿脐血与外周血早期血糖监测190例分析

目的探讨新生儿脐血血糖与新生儿外周血（足底血）血糖之间的关联性,为临床早期干预提供依据。方法选择100例妊娠期无并发症及合并症的正常妊娠分娩且新生儿Apgar评分≥8分的新生儿;90例“高危儿”病例作为对照,其中妊高征30例,早产儿30例,糖尿病30例。分娩时即时抽取脐静脉血送化验室查血糖、糖化血红蛋白,同时取脐血及新生儿足底血查快速血糖值。结果快速血糖值与化验室报告血糖值有一致性,脐血血糖与外周血血糖具有显著正相关性。正常妊娠分娩的新生儿中有5％比率的低血糖。结论为避免忽略正常新生儿中的低血糖患者,可用无创的脐血查快速血糖代替新生儿足底血血糖的测定,以减少对新生儿的损伤。     

全自动血型分析仪在血站血型筛查工作中的应用

目的探讨并评价全自动血型分析仪应用于血站献血者血型筛查的可行性。方法采用全自动血型分析仪(全自动法)对20 335例献血者标本进行ABO及Rh(D)血型鉴定、盐水不规则抗体初筛,并与U型微板法(半自动法)进行比对试验。结果全自动法与半自动法比较,ABO血型1次准确定型率:99.93%98.84%,差异无统计学意义(P0.05);Rh-D血型鉴定正确率均为100.0%;O细胞凝集阳性率:0.13%0.06%,差异有统计学意义(P0.05);可保持反定型检测准确度达100.0%的血浆稀释倍数为1∶64,高于1∶4;脂血标本和溶血标本导致的误判率差异有统计学意义(P0.05)。结论全自动血型分析仪具有较高的准确度、灵敏度及抗干扰能力,更易发现盐水不规则抗体,适合于血站开展献血者血型筛查工作。     

Effects of blood donation on cerebral blood flow velocity

Eighteen healthy male blood donors, nine with hematocrit (Hct) of 0.40 to 0.45 (normal Hct) and nine with Hct of 0.49 to 0.52 (upper-limit Hct), were monitored by continuous-wave internal carotid Doppler sonography and hematologic tests for 28 days after blood donation, to ascertain whether and to what extent a single standard donation may modify the velocity of cerebral blood flow. The two groups had similar mean predonation values of internal carotid flow velocity (ICFV): blood donation was followed in both groups by a slight, transient decrease of ICFV at the end of phlebotomy, due to donation-induced hypovolemia, and then by an increase of ICFV lasting 7 to 10 days. Analysis of individual profiles revealed that only four of nine upper-limit and six of nine normal Hct donors displayed a positive trend (increase) in the ICFV within the first week after donation, and that it was due mainly to a rise in systolic flow velocity. Mean Hct and arterial oxygen content showed a negative trend (decrease) within the first week that was opposite to the ICFV trend. Other laboratory variables, including serum proteins and plasma fibrinogen concentration, and the iron status indicators did not change, except for serum ferritin, which also decreased within the first week after phlebotomy. It can be concluded that blood donation may result in a short-term increase of blood flow velocity that is independent of Hct predonation levels in approximately one-half of the donors.     

Practical dosimetric aspects of blood and blood product irradiation

The method of choice to reduce susceptibility to transfusion-transmitted graft-versus-host disease is irradiation of allogenic blood and blood products for transfusion to immunosuppressed recipients. Optimal irradiation requires delivery of a known and homogeneous absorbed dose. The use of absorbed dose in air measured at the center of the irradiation volume without proper compensation for sample absorption can lead to approximately 20 percent underexposure. A lucite cylinder was used to provide the delivery of a homogeneous irradiation dose to blood products of different volumes by allowing rotation of the product.     

Effects of blood product storage protectants on blood coagulation

The ever-increasing demand for blood products challenges scientists to develop new and more effective techniques for their preservation. The progress of these novel preservation technologies uses a wide variety of cryoprotectant, lyoprotectant, and other preservatives, which will need to be explored and assessed for their biological effects during blood product formulation. The leading factor in protectant selection is for their ability to provide superior preservation for a particular blood product. We believe that such protectants used in blood product development should also be evaluated for their ability to preserve normal hemostasic mechanisms. In this review, high-molecular-weight cryoprotectants, lyoprotectants, polyols, amino acids, antioxidants, and surfactants, used because of their protective properties, were evaluated for their possible role in relation to their effect on normal hemostatic mechanisms.     

Return of autologous blood donors as homologous blood donors

Autologous blood donors (ABDs) have been reported to have favorable attitudes toward returning as homologous blood donors (HBDs), but the frequency of return has not been well documented. ABDs eligible by history to be HBDs were followed at one blood center: 255 donating for elective surgery and 234 donating during pregnancy were followed for an average of 18 months and 20 months, respectively, from time of eligibility after surgery or postpartum. Male ABDs had a higher rate of return as HBDs, as 34 percent (21/62) returned to donate an average of 3 units, whereas 13 percent (56/427) of female ABDs returned as HBDs to donate an average of 2 units. Although a history of donation was associated with a higher rate of return (30%, 34/113), 11 percent (43/376) of ABDs with no history as HBDs returned to donate homologous units, despite having been recruited less frequently than prior HBDs. Overall, all male ABDs and female ABDs with an HBD history returned most frequently. The extra effort required for an autologous donor program may result in the recruitment of new donors into the HBD pool.     

成分血制备环节全血暴露情况分析

目的评估分析成分血制备环节全血暴露的情况,为制定相应的预防控制措施提供依据,以降低成分血制备工作人员的职业暴露风险和减少血液资源浪费。方法在广州血液中心信息管理系统中统计2014—2017年成分血制备部每年需制备的全血袋数和全血暴露袋数,通过SPSS(22.0)软件对数据进行χ~2和线性趋势检验。结果 2014—2017年成分血制备的全血暴露率为0.081%,热合口漏、血袋漏和离心破袋引起的全血暴露率分别为0.038%,0.027%和0.016%。各年间全血暴露率差异有统计学意义(P0.05),其中热合口漏引起的全血暴露率呈不断上升趋势且有统计学意义(0.023%0.026%0.044%0.059%,P0.05)。结论热合口漏引起的成分血制备工作人员血源性职业暴露风险有上升的趋势,需进一步采取有效措施,同时不断加强血站工作人员预防职业暴露的意识,严格遵守和执行中心制定的规章制度。     

Enhanced nonenzymatic glycosylation of blood proteins in stored blood

Significantly enhanced nonenzymatic glycosylation of hemoglobin, plasma, and erythrocyte membrane proteins was demonstrated following storage of whole blood in the liquid state under conventional blood bank conditions. Among the blood components studied, the proteins of the erythrocyte membrane were mainly involved, although the levels of glycosylated hemoglobin and plasma proteins were also significantly increased. In contrast to the nonenzymatic glycosylation observed in vivo in patients with diabetes, the in vitro process is less intensive and most probably results in less functional alteration.