无创性连续血压测量初探

本文介绍了一种通过红外光电式换能器,在桡动脉处测量血液容积,从而反映血压值大小的无创性连续血压测量方法。并通过试验结果分析,证明所测得的电量与血压值是线性相关的     

关于加强血液成本控制的探索与分析

目的 通过梳理血液从采集到提供给临床整个过程血液成本的变化,探索血液成本控制管理举措。方法 通过对2015 - 2017年四川省某市级中心血站（以下简称A血站）从提高成分输血比例、提高采血量及400 ml/次的采集比例、加强血液采供各环节过程控制及强化内部管理来分析血液成本的变化。结果 成分输血率越高、采血量越大及400 ml/次采集比例越高、采供各环节及内部控制管理越好,血液成本均得到有效控制:三年间成分输血率分别提高3.2、2.3、3.0个百分点;采血量逐年增长6.46%、7.11%、8.36%,其中400 ml/次采集比例分别提升2.4、2.2、3.1个百分点;血液报废率逐年降低0.98、1.31、1.45个百分点。采取上述措施后血液成本逐年下降率分别为4.03%、4.47%、5.21%。结论 血站在严格遵守血液技术操作规程的前提下,可以通过提高成分血输血率、提高采血量及400 ml/次采集比例、加强采供各环节及内控管理来提升血液成本管理水平,这对各血站加强血液成本控制有一定的参考借鉴作用。     

血液回收机在外科手术中的应用效果对比观察

目的研究外科大手术中的患者使用血液回收机进行回收式自身输血在节约用血、减少输血不良反应及提高抢救成功率等方面的作用。方法将204例出血量比较大的外科患者随机分为两组,单数日的患者作为观察组,使用血液回收机进行回收式自身输血,双数日患者作为对照组全部输异体血。分别观察两组患者术中出血量、回收血量、输异体血量,输血不良反应及预后等情况。结果观察组106例患者共出血27．78×10^4ml,回收自体血（浓缩红细胞）12．78×10^4ml,按HCT为0．5计算,相当于全血25．56×10^4ml,回收率达92．10％。对照组98例患者共出血22．02×10^4ml,输异体血16．43×10^4ml;输血反应发生率：观察组为1．9％,对照组为11．2％,有显著性差异;死亡率：观察组为1．9％,对照组为5．1％,无显著性差异。结论利用血液回收机将术中失血收集,经过滤、清洗后再回输患者,节省了大量异体血,减少了输血反应,并能提高抢救成功率,值得推广和应用。     

Influence of postural changes on the variations of blood volume in hemodialysis and reincidence post-dialysis blood volume

The aim of the present work is to study the possible increment of blood volume, in the seated as well as the lying position, and to analyse the influence of changes of posture on the changes of blood volume during the hemodialysis. 17 patients were studied, evaluating the variations of the hematocrit in the extracorporeal circuit on entry into the dialyzer, by means of a photometric system (Crit-Line Instrument, Izasa). Every 15 minutes the values of the hematocrit were taken and heir repercussion in the blood volume in different changes of posture. Initially all of the patients improved their blood volume, both seated and lying down. During the session of hemodialysis and ultrafiltration, with the patient in a seated position, an important drop in the blood volume was noticed; this was the case in the 1st, 2nd and 3rd hours. This drop improved when the patient adopted a lying position and there was a "reincidence of post-dialysis blood volume" at the end. According to these results, the supine posture improves the refill, confirming that the patients position influences the vascular refill.     

青年脑出血急性期血肿体积与血压变异性的关系研究

目的：探讨青年脑出血患者的血压变异性（BPV）与急性期血肿体积的关系。方法：以首发青年脑出血（≤45岁）急性患者为研究对象,记录其人口统计学特征、神经功能缺失评分（NIHSS评分）;进行颅脑CT扫描,计算最大血肿体积;监测24小时动态血压、计算24小时收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）及血压变异度（BPV）;出院后随访其康复情况（mRS评分）。结果：患者收缩压变异度（SBPV）、舒张压变异度（DBPV）与血肿体积有显著关系（P〈0.05）;血肿体积及NIHSS评分与患者早期预后显著相关（P〈0．05）。结论：青年脑出血患者SBPV及DBPV增加可能提示血肿体积大,而后者常提示预后不佳。     

Calculation of impact blood volume by a rheogram

The approximated analytical expression for calculation of impact blood volume by using some parameters of a rheogram is derived on the basis of the authors' simple model of an elastic vessel having blood. The formula proposed to measure impact blood volume contains no empirical adjustable parameters is given.     

The efficient organization of blood donation

This paper models the costs of collecting whole blood in the north of Scotland in order to investigate strategies whereby the annual collection target can be met at lower cost. Data on the costs of the individual sessions held in 1993–1995 are analyzed using multilevel analysis. A new technique, namely the conditioned iterative generalized least squares (CIGLS) estimator is applied. Then the feasibility of collecting increased volumes from particular panels and areas is assessed by examining which factors determine the number of blood donors at a session. Results show that fixed cost and marginal cost vary across panels but marginal cost does not vary by volume. This implies that the cost-minimizing policy is to equalize marginal costs and collect higher volume at fewer panels (those with lower fixed costs). The level of donations can be increased by increasing the number of opportunities to donate and/or increasing the average length of a session. The latter policy is shown to be more cost-effective. Multilevel analysis proves not only to be appropriate but also particularly useful. © 1998 John Wiley & Sons, Ltd.     

可移动献血屋——一种全新的献血服务平台设计

目的：改善献血环境,保证充足的血液采集量,提高采血效果。方法：结合工作实际,与专用汽车生产企业合作研发,成功投入使用后对相关数据进行统计分析。结果：献血环境明显改善,降低了运行成本,血液采集的数量明显增加。结论：移动献血屋在保留其他外采方式优点的同时,尽力避免其不足,有效地解决了血站在闹市区建设献血屋不易获批的难题,同时为献血者提供了方便、安全、舒适的献血环境,是保障血液供应的有力举措。     

Estimation of menstrual blood loss volume based on menstrual diary and laboratory data

ABSTRACT: BACKGROUND: Abnormal uterine bleeding is often investigated in clinical studies and critical to identify during gynecological consultation. The current standard for quantification of menstrual blood loss is the alkaline-hematin-method. However, this method is expensive and inconvenient for patients. Bleeding diaries, although widely used, provide only qualitative information on menstrual blood loss. Other methods have been developed, but still do not provide reliable quantitative data. METHODS: We estimated blood loss volume using data from two clinical studies in women suffering abnormal menstrual bleeding. These estimations were derived from mixed linear models based on diary data, hematological parameters and age. To validate the models, we applied our results to data from a third study with a similar patient population. RESULTS: The resulting best fitting model uses diary entries on bleeding intensity at a particular day, information on occurrence and frequency of single bleeding intensities in defined time windows, hemoglobin and ferritin values and age of the patient all as predictors of menstrual blood loss volume. Sensitivity and specificity for the diagnosis of excessive bleeding were 87 % and 70 %, respectively. Our model-based estimates reflect the subjective assessment by physicians and patients in the same way as the measured values do.When applying the model to an independent study, we found a correlation of 0.73 between estimated and measured values for the blood loss in a single day. Further models with reduced number of parameters (simplified for easier practical use) still showed correlation values between 0.69 and 0.73. CONCLUSIONS: We present a method for estimating menstrual blood loss volume in women suffering from prolonged or excessive menstrual bleeding. Our statistical model includes entries from bleeding diaries, laboratory parameters and age and produces results which correlate well with data derived by the alkaline-hematin-method. Therefore, this model may be used to estimate menstrual blood loss volume in both routine gynecological counseling and clinical studies.     

Early high-sodium solid diet does not affect sodium intake, sodium preference, blood volume and blood pressure in adult Wistar-Kyoto rats

A high-Na diet may lead to the development of hypertension in both humans and rats; however, the causes of Na intake in amounts greater than physiologically needed as well as the mechanisms whereby high-Na food elevates blood pressure are not clear. Therefore, we decided to test the hypothesis that a high-Na diet introduced after suckling affects Na intake, food preference, resting blood pressure and blood volume in adult rats. Male Wistar-Kyoto (WKY) rats, 4 weeks old, were divided into three groups and placed on either a high-Na (3.28%), a medium-Na (0.82%) or a regular diet (0.22%) with the same energy content for 8 weeks. Subsequently, food preference, resting arterial blood pressure, blood volume, plasma osmolality and Na blood level were evaluated. When offered a choice of diets, all the groups preferred the regular chow, and there was no significant difference in total Na intake between the groups. When the rats experienced the change from their initial chow to a new one with different Na content, they continued to eat the same amount of food. Body weight, resting arterial blood pressure, blood volume, plasma osmolality and Na blood level were comparable between the groups. In conclusion, the results show that a high-Na diet introduced immediately after suckling does not affect Na preference and Na intake in adult WKY rats. Furthermore, the findings provide evidence that both blood volume and arterial blood pressure are highly protected in normotensive rats on a high-Na diet.     

在线血容量监测在血液透析患者数据信息系统的应用

目的：依据血容量监测的相关原理及监测方法,将血液透析患者在线血容量监测数据进行信息化管理。方法：将在线血容量监测仪所记载的血液透析患者的治疗参数通过相关技术形式对监测数据进行下载研究分析。结果：血容量监测可以直观了解患者透析过程中血容量的变化,有助于避免透析中低血压的发生,并可评价患者干体重。在充分获取数据的同时,有效利用血容量监测系统（BVMS）,对相关治疗数据进行下载、输出及编辑,实现了信息化管理。结论：通过掌握血容量变化（ΔBV）与血压关联性的画面构成,在一定程度上可以推测血压下降的原因;通过将监测数据相结合可有助于干体重的管理,有利血液透析患者数据信息的管理,并可根据患者临床表现结合血容量监测来确定合适的超滤量,调整干体重,制定适合的治疗方案。     

脑梗死患者血小板参数检测30例分析

目的:探讨血小板参数血小板计数PLT,血小板压积PCT,平均血小板体积MPV,血小板体积分布宽度PDW在脑梗死疾病中的变化。方法:全自动血液细胞分析仪检测30例脑梗死患者血小板4项参数,并与对照组正常人50例进行比较。结果:脑梗死患者的血小板计数PLT和血小板压积PCT明显减少,存在显著性差异(P<0.05),血小板体积分布宽度PDW、平均血小板体积MPV明显升高,存在显著性差异(P<0.05)。结论:血小板参数检测对脑梗死患者有重要意义。     

Equipment for extracorporeal blood oxygenation during hemosorption

A portable blood oxygenator is developed on the basis of the conventional sorption column. The prime volume of the oxygenator is up to 100 ml thus providing 100% saturation of the blood with oxygen at the perfusion rate of up to 300 ml/min. The device has been used in 54 hemosorption procedures for acute peritonitis, the improvement of the detoxication effect being observed.     

组合输液泵在连续性血液净化中的应用

目的：对出现肾功衰竭的32例患者进行血液净化治疗。方法：采用组合输液泵与单机血泵进行。根据临床需要设定输液泵的参数．包括治疗时间、置换液流量、透析液流量、加温器的温度和滤出液流量等。结果：32例病人病情均有不同程度的缓解．纠正了水潴留引起的急性左心衰、电解质紊乱和酸中毒、氮质血症得到缓解，保证了进一步治疗。结论：采用组合输液泵和单机血泵的方法是利用其具有可调节时间和输液量等功能，多台输液泵共同完成。简便易行，在没有经济条件购买CBP专用仪器的情况下．基本可以满足临床治疗的需要。     

The effect of copper iud on microcirculation of blood flow in rabbit uterus

A survey of the rabbit's normal microcirculation of blood flow volume in the endometrium and myometrium with or without a copper intrauterine device (IUD) was made. It was found through statistical analyses that the IUD stimulated the endometrium so that microcirculation of blood flow volume in the endometrium increased significantly, but it did not change the microcirculation of blood flow volume in the myometrium and in the opposite uterus.     

1180例新生儿脐血红细胞参数分析

目的:探讨影响新生儿脐血红细胞参数的因素。方法:采集1 180例新生儿脐血,利用全自动红细胞分析仪检测红细胞数(RBC)、血红蛋白含量(HB)、红细胞平均体积(MCV)、红细胞平均血红蛋白含量(MCH)、红细胞压积(HCT)、红细胞体积分布宽度(RDW)。分析不同性别、孕周及分娩方式新生儿脐血红细胞参数的差异。结果:男性新生儿的RBC、HB、HCT和RDW高于女性新生儿(P<0.05),MCV和MCH低于女性新生儿(P<0.05);足月产儿的HB、MCV、MCH和RDW低于早产儿(P<0.05);顺产新生儿的RBC、HB和HCT较剖宫产儿高(P<0.05)。结论:新生儿脐血红细胞参数受性别、孕周及分娩方式等因素的影响;了解新生儿红细胞参数,有助于某些遗传性血液病的早期筛查。     

Red blood cell and iron metabolism during space flight

Space flight anemia is a widely recognized phenomenon in astronauts. Reduction in circulating red blood cells and plasma volume results in a 10% to 15% decrement in circulatory volume. This effect appears to be a normal physiologic adaptation to weightlessness and results from the removal of newly released blood cells from the circulation. Iron availability increases, and (in the few subjects studied) iron stores increase during long-duration space flight. The consequences of these changes are not fully understood.     

骨科患者输血与医院感染

目的 探讨输血对骨科患者医院感染发生的影响.方法 采用回顾性试验方法,收集患者的基本资料,记录患者的输血量、输入血的性质及患者医院感染发生情况,选择2008年1-12月医院收治的骨科手术患者517例,其中未输血组251例,输异体血187例,输自体血79例;对3组患者的医院感染发生率进行比较.结果 未输血组患者医院感染率为2.39％,输异体血组医院感染率为9.63％,输自体血患者医院感染率为3.80％,不同输血方式组患者的医院感染率不全相同,差异有统计学意义(P＜0.05);对其进行两两比较后发现,输异体血组医院感染率高于其他两组,未输血组患者医院感染率与输自体血患者医院感染率差异无统计学意义;输异体血量各组之间与医院感染发生率差异有统计学意义(P＜0.05),输自体血量各组之间与医院感染发生率差异无统计学意义.结论 输自体血患者与输异体血患者医院感染发生与输血成分及输血量等有关;在保证患者循环稳定的情况下,应尽量减少输血,对确需输血的患者,应该在条件允许的情况下输注自体血.     

The blood picture in contraception

Changes which may occur in the blood in women using IUDs or oral contraceptives are discussed. All experience with IUDs shows that menstrual flow is increased in most women, at least at first. The taking of oral contraceptives, especially the combined estrogen-progestagen type, usually results in a decrease in menstrual flow. Most of the evidence is subjective, but Nilsson and Solvell did measure the loss quantitatively and found that the average amount of blood lost was halved in women using oral contraceptives. In a survey of 219 women attending a Family Planning Association clinic in London, it was found that IUDs tended to lower the hemoglobin level and other values, and oral contraceptives to raise them. In a study of women using pessaries and women using oral contraceptives, the serum iron level, total iron-binding capacity, and packed cell volume were significantly higher in women taking oral contraceptives. In a study of IUD users, a fall in the hemoglobin level was shown in 22 out of 40 users at the end of 1 year, but only 9 had a decrease of more than 1.5 g per 100 ml, and 8 showed an equivalent increase. By far the greatest number of removals of IUD is for menorrhagia. If this could be controlled or eliminated, the acceptability of this method would increase. The author has found that the IUD is more often taken out because the menstrual pattern is unacceptable and difficult to treat than because it is causing an iron-deficiency anemia, which is treatable. Perhaps iron should be given routinely to IUD users. More studies are needed to clarify the blood picture in IUD and oral contraceptive users.