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红细胞贮存时间对输血后小鼠体内炎症反应和补体活化的影响
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作者 张嘉敏 高文杰 +3 位作者 李勤 赵俸涌 郭忠慧 朱自严 《中国输血杂志》 CAS 2019年第9期870-874,共5页
目的探讨红细胞体外贮存时间延长对小鼠输血后炎症反应的影响及补体在其中的作用。方法30-35只C57BL/6小鼠,摘眼球取血,滤白后加入红细胞保存液,4℃贮存。在35 d贮存期中,每7 d给小鼠(n≥3)尾静脉注射红细胞500μL/次;每次输注后2、24 h... 目的探讨红细胞体外贮存时间延长对小鼠输血后炎症反应的影响及补体在其中的作用。方法30-35只C57BL/6小鼠,摘眼球取血,滤白后加入红细胞保存液,4℃贮存。在35 d贮存期中,每7 d给小鼠(n≥3)尾静脉注射红细胞500μL/次;每次输注后2、24 h,从小鼠眼眶采血300μL/只,离心分离血浆用于流式检测炎症因子浓度,ELISA检测补体活性片段浓度;用抑制剂FUT-175完成补体抑制试验,检测血浆中炎症因子和补体活性片段浓度。结果0 d,24 h血样检测,炎症因子(pg/mL):TNF(21.69±6.12)、IFN-γ(4.72±1.85)、MCP-1(132.91±37.41)、IL-10(2.56±1.72)、IL-6(78.80±51.07)、IL-12p70(1.95±1.43);补体活性(ng/mL):C3a(604.00±120.00)、C5a(63.63±13.09)、C4a(586.81±146.07);35 d,24h血样检测:炎症因子(pg/mL):TNF(407.74±33.38)、IFN-γ(133.39±25.28)、MCP-1(3 317.53±358.26)、IL-10(2 769.54±615.36)、IL-6(12 856.92±2339.47)、IL-12p70(1.96±2.00);补体活性(ng/mL):C3a(1 660.00±16.00)、C5a(608.72±33.74)、C4a(490.95±45.88)。随着小鼠输注贮存时间越长的红细胞,其血浆中TNF、IFN-γ、MCP-1、IL-10、IL-6、C3a、C5a浓度明显升高(P<0.05),而IL-12p70和C4a浓度无明显变化(P>0.05)。抑制补体后,小鼠血浆中MCP-1、IL-6浓度下降明显(P<0.01,P<0.05)。结论红细胞贮存损伤引起小鼠输血后体内发生炎症反应,补体参与其中,旁路途径可能是补体激活的主要途径。 展开更多
关键词 红细胞贮存 贮存损伤 输血 补体 炎症反应 输血反应
体外循环中限制性输血策略的质量控制与成效评价初探 预览
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作者 张巧妮 刘刚 +1 位作者 刁晓林 吉冰洋 《中国体外循环杂志》 2019年第4期202-205,共4页
目的回顾总结阜外医院成人体外循环科限制性输血策略的质量控制工作,对初期成效进行评价。方法阜外医院成人体外循环科自2018年1月1日起严格执行本院外科输血规范,同时建立“临床用血核查表”电子信息系统,并基于医院电子病历系统建立... 目的回顾总结阜外医院成人体外循环科限制性输血策略的质量控制工作,对初期成效进行评价。方法阜外医院成人体外循环科自2018年1月1日起严格执行本院外科输血规范,同时建立“临床用血核查表”电子信息系统,并基于医院电子病历系统建立围体外循环期临床数据库,对患者输血及相关信息进行全面采集。分别纳入科室质控前与质控后的体外循环患者,对比两组患者输血情况与相关临床指标。结果两组患者基线可比。与质控前相比,质控后围体外循环期红细胞输注率显著下降(P<0.05),院内死亡率与主要并发症发生率的差异无统计学意义(P>0.05)。结论通过科室内部综合质量控制方法,体外循环中限制性输血策略的安全性及有效性得到初步证实。 展开更多
关键词 科室质量控制 心血管手术 输血 限制性输血策略
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Analysis of Factors Influencing True Blood Loss in Navigated Total Knee Replacements 预览
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作者 Laghvendu Shekhar Yogesh Salphale 《外科学(英文)》 2019年第2期59-69,共11页
Title: Analysis of factors influencing true blood loss in navigated total knee replacements. Objectives: To evaluate true blood loss in total knee replacements and analyze the various factors such as gender, BMI, diag... Title: Analysis of factors influencing true blood loss in navigated total knee replacements. Objectives: To evaluate true blood loss in total knee replacements and analyze the various factors such as gender, BMI, diagnosis, size of implants, duration of surgery, tourniquet usage etc. on calculated blood loss using formula by Nadler et al. All the cases included have been done using navigation system and no comparison with conventional jig based surgeries has been attempted. Methods: Retrospectively data of primary cemented total knee replacements performed from October 2012 to August 2013 were evaluated. All surgeries were performed using navigation system. The data collected included patient sex, height, weight and preoperative haemoglobin and hematocrit. The patients’ postoperative data of haemoglobin, hematocrit and drains were collected. All patients had their CBC done on 2nd post operative day. Any data on transfusions that patients received were also collected. We also collected data regarding the size of implant used. We calculated true blood based on formula given by Nadler, Hidalgo & Bloch. We excluded patients whose data were incomplete or who received tranexamic acid. Patients who needed stems (femoral or tibial) were also excluded from this study. Results: The average true calculated blood loss was 959.44 ml. BMI did not have any effect on blood loss. But larger size implants were associated with more blood loss. Conclusion: The preoperative haemoglobin is one of the most important factors in determining transfusion following the knee replacement. Male gender and larger implants are associated with more blood loss. BMI, diagnosis of OA or RA, tourniquet usage and time have no significant effect on blood loss. Our calculated blood loss compares favourably with published literature. 展开更多
关键词 Navigated TOTAL KNEE Replacements BLOOD LOSS TRANSFUSION
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高抗-D效价孕产妇产前管理及新生儿救治
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作者 凤婧 袁佳 +3 位作者 王海娟 赵虹 朱凯 陈剑 《中国输血杂志》 CAS 2019年第2期171-174,共4页
目的通过对14例抗-D效价≥128孕妇(其中1例为双胎妊娠)的孕期临床干预与产后新生儿治疗的分析,总结及分享本院监测、治疗母亲高抗-D效价致新生儿溶血病的方法经验。方法分析总结2013年1月-2017年6月到本院产科门诊就诊的RhD阴性且抗-D... 目的通过对14例抗-D效价≥128孕妇(其中1例为双胎妊娠)的孕期临床干预与产后新生儿治疗的分析,总结及分享本院监测、治疗母亲高抗-D效价致新生儿溶血病的方法经验。方法分析总结2013年1月-2017年6月到本院产科门诊就诊的RhD阴性且抗-D效价≥128的孕妇共14例,建卡后均行抗-D效价监测、胎监、MCA-PSV,S/D,并依据检测结果确定终止妊娠时机。新生儿娩出后,立即送脐血检测新生儿溶血病3项试验及血常规、肝功能,结合临床表现和实验室检测结果,给予新生儿溶血病的相关治疗。结果 14例高抗-D效价母亲生产的15例新生儿出生后均发生HDFN,经积极治疗后,均预后良好,未发生胆红素脑病及其它不良后果。结论本院现行的HDFN监测和救治策略,使高抗-D效价母亲生产的重度HDFN患儿得到成功救治,为此类患者的临床管理提供了良好的经验,值得借鉴。 展开更多
关键词 RHD阴性 抗体效价 新生儿溶血病 输血 换血
红细胞存储损伤与临床输注不良后果间的关系 预览
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作者 李姝 杨丽丽 +1 位作者 魏春华 苏燕 《动物医学进展》 北大核心 2019年第7期124-127,共4页
输血是流体复苏的重要组成部分,常用于急性大失血、烧伤、贫血以及严重创伤患者,在改善机体组织供氧和凝血功能、挽救生命的过程中起着无法替代的地位和作用。异体存储血液目前仍是输血的主要来源,然而,存储血液对于红细胞(RBCs)来说不... 输血是流体复苏的重要组成部分,常用于急性大失血、烧伤、贫血以及严重创伤患者,在改善机体组织供氧和凝血功能、挽救生命的过程中起着无法替代的地位和作用。异体存储血液目前仍是输血的主要来源,然而,存储血液对于红细胞(RBCs)来说不是一种自然的存在状态。在低温存储过程中,RBCs在生化和能量代谢、氧化还原代谢、细胞形态等诸多方面经历了相当大的变化,且随着存储时间的延长,变化更加显著,即"存储损伤"。目前,RBCs存储损伤机制已经基本明确,但RBCs存储损伤是否会影响临床输注不良后果,一直是专家争论的焦点,也是输血界研究的热点。 展开更多
关键词 输血 红细胞 存储损伤 不良后果
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Induction of differentiation of human stem cells ex vivo:Toward large-scale platelet production 预览
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作者 Xiao-Hua Lei Yi-Qing Yang +1 位作者 Chi-Yuan Ma En-Kui Duan 《世界干细胞杂志:英文版(电子版)》 2019年第9期666-676,共11页
Platelet transfusion is one of the most reliable strategies to cure patients suffering from thrombocytopenia or platelet dysfunction.With the increasing demand for transfusion,however,there is an undersupply of donors... Platelet transfusion is one of the most reliable strategies to cure patients suffering from thrombocytopenia or platelet dysfunction.With the increasing demand for transfusion,however,there is an undersupply of donors to provide the platelet source.Thus,scientists have sought to design methods for deriving clinical-scale platelets ex vivo.Although there has been considerable success ex vivo in the generation of transformative platelets produced by human stem cells(SCs),the platelet yields achieved using these strategies have not been adequate for clinical application.In this review,we provide an overview of the developmental process of megakaryocytes and the production of platelets in vivo and ex vivo,recapitulate the key advances in the production of SC-derived platelets using several SC sources,and discuss some strategies that apply three-dimensional bioreactor devices and biochemical factors synergistically to improve the generation of large-scale platelets for use in future biomedical and clinical settings. 展开更多
关键词 Megakaryopoiesis PLATELET PRODUCTION TRANSFUSION Bioreactors Stem cells
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Review of abdominal solid organ transplantation in Jehovah’s Witness patients 预览
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作者 Rodrigo S Figueiredo Rohan G Thakkar +1 位作者 Paul R Ainley Colin H Wilson 《世界移植杂志》 2019年第5期94-102,共9页
Managing blood loss in Jehovah’s Witness(JW)patients is a matter of controversy.These patients will not accept transfusions of red blood cells,white blood cells,platelets or plasma,even if that is required to save th... Managing blood loss in Jehovah’s Witness(JW)patients is a matter of controversy.These patients will not accept transfusions of red blood cells,white blood cells,platelets or plasma,even if that is required to save their lives.There are many discussions regarding safety of operating upon JW patients in general surgical procedures,but in solid organ transplantation there is a paucity of literature on this subject.We have reviewed individual case reports and small series documenting on experience with solid organ transplantation in JW patients and the strategies adopted to facilitate that.It is clear that such patients require the surgical team to dedicate more time to ensure their safe management.This begins with a thorough,detailed consent of exactly which products and interventions they will or will not accept.Planning must begin weeks before surgery if possible.Each case must be assessed individually,but provided they meet fitness requirements,there are no absolute contraindications to abdominal organ transplantation. 展开更多
关键词 ANAEMIA Blood TRANSFUSION INFORMED consent Jehovah's WITNESS TRANSPLANTATION
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Letter to the editor:Diagnosis of erythropoietic protoporphyria with severe liver injury-a case report 预览
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作者 Debby Wensink Margreet AEM Wagenmakers +1 位作者 JH Paul Wilson Janneke G Langendonk 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第30期4292-4293,共2页
Erythropoietic protoporphyria(EPP)is an extremely rare disease which is often unrecognized as diagnosis.In the recent article Lui et al describe a patient with a new diagnosis of EPP with severe liver injury.Approxima... Erythropoietic protoporphyria(EPP)is an extremely rare disease which is often unrecognized as diagnosis.In the recent article Lui et al describe a patient with a new diagnosis of EPP with severe liver injury.Approximately 5%-20%of patients with EPP develop liver manifestations.The most severe complication of EPP is an hepatic crisis,which is a medical emergency requiring urgent treatment.Intensive treatment should consist of(exchange)transfusions and preferably in a center that performs liver transplantations. 展开更多
关键词 Erythropoietic protoporphyria Liver disease BLOOD TRANSFUSION PROTOPORPHYRIN IX Treatment
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肿瘤患者PICC置管后皮肤损伤的预防及护理干预 预览
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作者 郭菁 《中西医结合护理(中英文)》 2019年第5期124-126,共3页
目的探讨肿瘤患者经外周静脉置入中心静脉导管(PICC)穿刺部位皮肤损伤预防及护理干预措施。方法选取2017年1月—12月行PICC置管的患者488例为对照组,PICC置管期间采用常规护理。选取2018年1月—12月行PICC置管的患者553例为试验组,在对... 目的探讨肿瘤患者经外周静脉置入中心静脉导管(PICC)穿刺部位皮肤损伤预防及护理干预措施。方法选取2017年1月—12月行PICC置管的患者488例为对照组,PICC置管期间采用常规护理。选取2018年1月—12月行PICC置管的患者553例为试验组,在对照组基础上实施针对性护理干预。观察2组PICC穿刺部位机械性损伤、接触性皮炎发生情况。结果试验组PICC穿刺部位机械性损伤、接触性皮炎发生率低于对照组,差异有统计学意义(P<0.05)。结论护理干预措施能有效降低肿瘤患者PICC皮肤损伤率,减轻患者痛苦。 展开更多
关键词 经外周静脉穿刺置入中心静脉导管 皮肤损伤 肿瘤 接触性皮炎 输液 放疗 化疗
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1例输血性恶性疟病例实验室诊断与流行病学分析
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作者 朱韩武 何卓 +4 位作者 黄友军 周虹 谭徽 李正祥 王艳琴 《中国媒介生物学及控制杂志》 CAS 2019年第4期448-450,共3页
目的通过对1例输血性恶性疟病例实验室诊断和流行病学分析,为当地输入疟疾防治提供科学依据。方法收集和分析患者病历资料、流行病学资料以及供血者流行病资料;对患者血样进行疟原虫镜检、疟疾快速试纸条(RDT)和巢式PCR方法检测。结果... 目的通过对1例输血性恶性疟病例实验室诊断和流行病学分析,为当地输入疟疾防治提供科学依据。方法收集和分析患者病历资料、流行病学资料以及供血者流行病资料;对患者血样进行疟原虫镜检、疟疾快速试纸条(RDT)和巢式PCR方法检测。结果患者无外出史、无疟疾既往病史、有输血史,外周血涂片查见恶性疟原虫,RDT为单一恶性疟阳性,巢式PCR为恶性疟阳性;随访给患者供血者,有境外疟疾流行区外出史和疟疾既往病史,血样RDT为单一恶性疟原虫阳性,但疟原虫镜检阴性。结论该患者为输血引起的恶性疟病例,建议相关部门加强献血者献血时疟疾筛查工作,以避免类似因输血引起的疟疾病例发生。 展开更多
关键词 恶性疟原虫 输血 疟疾流行病学史 湖南郴州
Not Just Surviving But Thriving 预览
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作者 MA LI 《今日中国:英文版》 2019年第4期32-34,共3页
"Private enterprises must have internal impetus to grow. If you have strong internal impetus driving physical growth, you will have strong hematopoietic function. If you only rely on blood transfusion, you cannot... "Private enterprises must have internal impetus to grow. If you have strong internal impetus driving physical growth, you will have strong hematopoietic function. If you only rely on blood transfusion, you cannot stay healthy,” said Ma Yushan, chairman of Ningxia Wuzhong Instrument Co., Ltd., on March 6.“Internal impetus is the foundation of enterprise survival, and innovation is the only way for enterprise development.” 展开更多
关键词 Thriving BLOOD TRANSFUSION Ningxia Wuzhong Instrument Co. Ltd.
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Impact of perioperative transfusion in patients undergoing resection of colorectal cancer liver metastases:A population-based study 预览
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作者 Bo Long Zhen-Nan Xiao +2 位作者 Li-Hua Shang Bo-Yan Pan Jun Chai 《世界临床病例杂志》 2019年第10期1093-1102,共10页
BACKGROUND Perioperative allogeneic blood transfusion is associated with poorer outcomes.AIM To identify the factors that were associated with perioperative transfusion and to examine the impact of perioperative trans... BACKGROUND Perioperative allogeneic blood transfusion is associated with poorer outcomes.AIM To identify the factors that were associated with perioperative transfusion and to examine the impact of perioperative transfusion in patients undergoing resection of colorectal cancer(CRC)liver metastases.METHODS The United States National Inpatient Sample(NIS)database was searched for patients with CRC who received surgery for liver metastasis.Linear and logistic regression analyses were performed.RESULTS A total of 2018 patients were included,and 480 had a perioperative transfusion.Emergency admission(adjusted odds ratio[aOR]=1.42;95%CI:1.07-1.87),hepatic lobectomy(aOR=1.76;95%CI:1.42-2.19),and chronic anemia(aOR=2.62;95%CI:2.04-3.35)were associated with increased chances of receiving a transfusion,but receiving surgery at a teaching hospital(aOR=0.75;95%CI:0.58-0.98)was associated with a decreased chance of receiving a transfusion.Receiving a perioperative transfusion was significantly associated with increased in-hospital mortality(aOR=3.38;95%CI:1.57-7.25),and increased overall postoperative complications(aOR=1.67;95%CI:1.31-2.13),as well as longer length of hospital stay CONCLUSION Patients with an emergency admission,hepatic lobectomy,chronic anemia,and who have surgery at a non-teaching hospital are more likely to receive a perioperative transfusion.Patients with CRC undergoing surgery for hepatic metastases who receive a perioperative transfusion are at a higher risk of inhospital mortality,postoperative complications,and longer length of hospital stay. 展开更多
关键词 Colorectal cancer Liver metastasis PERIOPERATIVE BLOOD TRANSFUSION INTRAOPERATIVE BLOOD loss National INPATIENT sample
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冠状动脉旁路移植术患者术前贫血与围术期并发症的相关性研究 预览
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作者 肖红艳 陶翠华 +1 位作者 宋来春 陶凉 《中国心血管病研究》 CAS 2019年第8期759-763,共5页
目的通过回顾性分析,研究冠状动脉旁路移植(CABG)患者术前贫血与术后输血量及其他并发症之间的相关性.方法回顾性对比研究我院2018年1~6月择期行CABG的患者,排除术前3个月内有出血、术前血小板计数<100×109/L、血液病、术后因... 目的通过回顾性分析,研究冠状动脉旁路移植(CABG)患者术前贫血与术后输血量及其他并发症之间的相关性.方法回顾性对比研究我院2018年1~6月择期行CABG的患者,排除术前3个月内有出血、术前血小板计数<100×109/L、血液病、术后因外科因素导致的二次开胸手术患者;按照贫血诊断标准,将符合人选标准的患者分为正常组和贫血组,贫血组再分为轻度贫血组和中度贫血组.收集患者术前的基础资料以及术后的输血量、输血率、肝功能损害、肾功能损害、住ICU时间、住院时间及住院死亡率.结果最终符合人选标准的患者共计389例,其中正常组306例(78.67%),贫血组83例(21.34%),轻度贫血77例(19.80%),中度贫血6例(1.54%);正常组和贫血组术前基线资料上除血红蛋白含量存在显著差异外,年龄、糖尿病、慢性肾脏病(CKD)、既往心脏手术例数贫血组高于正常组,体重指数(BMI)和术前血小板计数贫血组低于正常组,差异均有统计学意义(P<0.05);术后住院死亡率两组无差异,贫血组急性肝肾功能损害、红细胞、血浆、血小板补充量、输血率、住ICU时间及住院时间均高于正常组,差异有统计学意义(P<0.05);轻度和中度贫血组基线资料除血红蛋白含量外其他均无差异性,术后中度贫血组除红细胞补充量多于轻度贫血组外,其他均无显著性差异.结论高龄、合并糖尿病、CKD、营养不良和既往曾行心脏外科手术是冠心病术前贫血患者的高危因素,术前贫血增加CABG患者术后的输血量,并导致术后肝肾功能损害和延长住ICU时间及住院时间;围术期严格把握输血指征,及时的成分输血纠正贫血,中度贫血患者行CABG手术是安全的. 展开更多
关键词 贫血 冠状动脉旁路移植 输血 并发症
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显微镜下脑动静脉畸形切除术中输血治疗的危险因素分析
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作者 刘清源 王诺川 +4 位作者 吴俊 姜朋军 曹勇 张亚南 王硕 《北京医学》 CAS 2019年第4期310-314,共5页
目的分析显微镜下脑动静脉畸形切除术中输血治疗的危险因素分析.方法回顾性分析2015年8月至2017年12月首都医科大学附属北京天坛医院神经外科手术切除的109例脑动静脉畸形患者的术前临床、影像学资料,将术中出血量和体质量的比值定义为... 目的分析显微镜下脑动静脉畸形切除术中输血治疗的危险因素分析.方法回顾性分析2015年8月至2017年12月首都医科大学附属北京天坛医院神经外科手术切除的109例脑动静脉畸形患者的术前临床、影像学资料,将术中出血量和体质量的比值定义为出血体质量比值(BTW).主要终点事件为术中和术后48 h内是否输血,次要终点事件为术中患者的Hb是否有显著降低.采用logistic回归分析输血治疗的危险因素,采用ROC曲线分析术中出血量和BTW对于术中Hb降低的判断价值.结果109例患者中,39例接受输血治疗(35.8%).术中输血组和未输血组在体质量(P=0.030)、既往破裂史(P=0.009)、术中出血量(P<0.001)、BTW(P<0.001)、术中Hb(P=0.002)、手术时长(P<0.001)、病灶大小(P=0.047)、Spetzler-Martin分级(P<0.001)和病灶类型(P<0.001)方面差异均有统计学意义.Logistics回归分析显示,术中出血量(OR=2.83,P=0.008)、BTW(OR=4.92,P=0.001)、Spetzler-Martin分级(OR=2.44,P<0.001)及病灶类型(OR=6.25,P<0.001)是术中需行输血治疗的独立危险因素.Spetzler-Martin分级(AUC=0.787,P<0.001)和病灶类型(AUC=0.768,P<0.001)是输血治疗风险的良好预测因素.BTW对于术中Hb显著降低的预测价值(AUC=0.865,P<0.001)高于术中出血量(AUC=0.783,P<0.001).结论术中出血量、BTW、Spetzler-Martin分级和病灶类型是脑动静脉畸形在术中行输血治疗的独立危险因素.随着Spetzler-Martin分级升高,患者需要输血治疗的风险也逐渐升高.弥散脑动静脉畸形是需要接受输血治疗的重要危险因素之一.相比于术中出血量,BTW能更加准确地判断患者术中发生出血后Hb显著降低的情况. 展开更多
关键词 脑动静脉畸形 输血 弥散病灶 Spetzler-Martin分级 影像学
基于第六版JCI标准的门急诊输液应急预案构建 预览
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作者 李浩 施芳红 +3 位作者 黄诗颖 张顺国 陈敏玲 魏继福 《中国卫生质量管理》 2019年第3期44-46,共3页
第六版JCI标准新增了“保障医疗业务连续性”内容。依据门急诊输液日常流程,在信息系统重大更新前,构建门急诊输液应急预案,可以在医疗机构信息系统宕机期间保障医疗业务的连续性。预案构建后,在信息系统重大更新前后,共发生6次系统无... 第六版JCI标准新增了“保障医疗业务连续性”内容。依据门急诊输液日常流程,在信息系统重大更新前,构建门急诊输液应急预案,可以在医疗机构信息系统宕机期间保障医疗业务的连续性。预案构建后,在信息系统重大更新前后,共发生6次系统无法正常运行的情况,其间均未发生调配差错。 展开更多
关键词 第六版JCI标准 门急诊 输液 应急预案
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静脉药物配置中心抗肿瘤药物使用的合理性分析 预览
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作者 蔡莉 陈文静 冼宝珍 《中国当代医药》 2019年第16期205-208,共4页
目的通过对静脉药物配置中心(PIVAS)抗肿瘤药物处方中抗肿瘤药使用的合理性进行分析,为今后临床抗肿瘤药物的用药安全性和有效性提供参考依据。方法回顾性分析2014年8月~2017年8月我院PIVAS调配的2000组抗肿瘤药物处方,依据各类抗肿瘤... 目的通过对静脉药物配置中心(PIVAS)抗肿瘤药物处方中抗肿瘤药使用的合理性进行分析,为今后临床抗肿瘤药物的用药安全性和有效性提供参考依据。方法回顾性分析2014年8月~2017年8月我院PIVAS调配的2000组抗肿瘤药物处方,依据各类抗肿瘤药物说明书,参考相关药物使用标准(如药典、新编药物学、中国国家处方集、临床静脉用药调配与使用指南等),以及国家食品药品监督管理总局(CFDA)和美国FDA发布的相关警告等,统计处方中溶剂的用量和选择是否合理,抗肿瘤药物的给药途径、剂量、给药顺序及其他不合理用药情况;统计常见抗肿瘤药物的溶媒、浓度、输注时间的选择;统计抗肿瘤药物联合用药的给药顺序。结果 2000组处方中共有127组处方不合格,所占比例为6.35%,其中溶剂不合理占70.08%(89/127),表现为用量不当和选择不当;抗肿瘤药不合理占22.05%(28/127),包括给药途径不合理、剂量不合理及给药顺序不合理;其他不合理占7.09%(9/127)。不同抗肿瘤药所用溶剂、药液稳定性存在差异,因此临床输注时间、注意事项不同。在临床抗肿瘤药物联合应用时有一定的给药顺序,若用药顺序错误会影响药物的抗肿瘤效果或引发严重的不良反应。结论PIVAS抗肿瘤药物的使用存在处方不合理的问题,主要为溶剂用量不当、选择不当、抗肿瘤药给药途径不合理、剂量不合理、给药顺序不合理等,医院需要加强对上述问题的审核,保证抗肿瘤药物的质量和合理使用。 展开更多
关键词 抗肿瘤药 处方 静脉药物配置中心 输液
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孕妇血浆宽热振幅抗-HI复合抗体检测
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作者 邵林楠 宋文倩 +2 位作者 王霓 周世航 于卫建 《国际输血及血液学杂志》 CAS 2019年第5期425-428,共4页
目的探讨宽热振幅抗-HI复合抗体的鉴定及其特征。方法选择2017年3月因产前检查不规则抗体筛查结果呈阳性,于大连市血液中心血型室进行不规则抗体特异性鉴定的1例孕妇为研究对象。该例孕妇年龄为27岁,孕龄为37孕周,血型为AB型RhD阳性,既... 目的探讨宽热振幅抗-HI复合抗体的鉴定及其特征。方法选择2017年3月因产前检查不规则抗体筛查结果呈阳性,于大连市血液中心血型室进行不规则抗体特异性鉴定的1例孕妇为研究对象。该例孕妇年龄为27岁,孕龄为37孕周,血型为AB型RhD阳性,既往经剖宫产育有一存活子女,无输血治疗史。采集孕妇及其丈夫肘正中静脉血各5 mL,用于血型鉴定、直接抗人球蛋白试验,以及不规则抗体筛查和鉴定。直接抗人球蛋白试验采用试管法;血型鉴定、免疫球蛋白(Ig)M性质不规则抗体筛查和鉴定,均采用盐水试管法。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求,并与受试者签署临床研究知情同意书。结果①本例孕妇的ABO血型正定型为A1B型,反定型A细胞为阴性,B细胞弱凝集,O细胞凝集强度为2+。其ABO血型的正、反定型不符,并且存在不规则抗体。②本例孕妇直接抗人球蛋白试验结果显示,抗IgG和抗C3d均呈阴性。③本例孕妇不规则抗体筛查与鉴定结果显示,其血浆中存在IgM性质宽热振幅抗-HI复合抗体。结论对于携带宽热振幅抗-HI复合抗体的患者,应采用多种方法及试剂,对其复合抗体进行筛查和鉴定。以避免此类患者输注ABO不匹配红细胞。 展开更多
关键词 抗体 抗-HI 复合抗体 输血 抗体筛查 泛凝集
Prediction of massive transfusion in trauma patients in the surgical intensive care units (THAI-SICU study)
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作者 Osaree Akaraborworn Onuma Chaiwat +8 位作者 Sunisa Chatmongkolchart Chanatthee Kitsiripant Kaweesak Chittawatanarat Sunthiti Morakul Thammasak Thawitsri Petch Wacharasintg Sujaree Poopipatpab Waraporn Chau-In Chaiyapruk Kusumaphanyo 《中华创伤杂志:英文版》 CAS CSCD 2019年第4期219-222,共4页
Purpose: After damage control surgery, trauma patients are transferred to intensive care units to restore the physiology. During this period, massive transfusion might be required for ongoing bleeding and coagulopathy... Purpose: After damage control surgery, trauma patients are transferred to intensive care units to restore the physiology. During this period, massive transfusion might be required for ongoing bleeding and coagulopathy. This research aimed to identify predictors of massive blood transfusion in the surgical intensive care units (SICUs). Methods: This is an analysis of the THAI-SICU study which was a prospective cohort that was done in the 9-university-based SICUs in Thailand. The study included only patients admitted due to trauma mechanisms. Massive transfusion was defined as received >10 units of packed red blood cells on the first day of admission. Patient characteristics and physiologic data were analyzed to identify the potential factors. A multivariable regression was then performed to identify the significant model. Results: Three hundred and seventy patients were enrolled. Sixteen patients (5%) received massive transfusion in the SICUs. The factors that significantly predicted massive transfusion were an initial sequential organ failure assessment (SOFA)>9 (risk difference (RD) 0.13, 95% confidence interval (CI): 0.03—0.22, p = 0.01);intra-operative blood loss > 4900 mL (RD 0.33, 95% CI: 0.04—0.62, p = 0.02) and intra-operative blood transfusion > 10 units (RD 0.45, 95% Cl: 0.06 to 0.84, p = 0.02). The probability to have massive transfusion was 0.976 in patients who had these 3 factors. Conclusion: Massive blood transfusion in the SICUs occurred in 5%. An initial SOFA >9, intra-operative blood loss >4900 mL, and intra-operative blood transfusion >10 units were the significant factors to predict massive transfusion in the SICUs. 展开更多
关键词 MASSIVE TRANSFUSION MASSIVE BLEEDING SURGICAL INTENSIVE care Multiple TRAUMA
常见输血不良反应发生率及相关危险因素探讨
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作者 徐燕娜 纪勇平 +1 位作者 杨慧 庄杰 《中国卫生检验杂志》 CAS 2019年第6期757-759,共3页
目的了解本市临床输血不良反应发生率及相关危险因素,为减少输血不良反应提供依据。方法以2015年-2017年本市某三甲医院接受输血患者为研究对象,回顾性分析研究期间输血不良反应发生率、不良反应类型、各输血成分不良反应发生率及输血... 目的了解本市临床输血不良反应发生率及相关危险因素,为减少输血不良反应提供依据。方法以2015年-2017年本市某三甲医院接受输血患者为研究对象,回顾性分析研究期间输血不良反应发生率、不良反应类型、各输血成分不良反应发生率及输血不良反应的影响因素。结果3年共计成分输血33614人次(血制品47 452袋),发生输血不良反应175人次,输血不良反应发生率为0.52%;3年的输血不良反应发生率依次分别是0.58%、0.50%和0.48%。不良反应类型的构成比过敏反应、发热反应分别为56.0%和41.7%。输悬浮红细胞、血浆、机采血小板和全血不良反应发生率分别为0.53%、0.27%、0.22%和0.40%。是否成年、有无妊娠史和输血史明显影响输血不良反应的发生率。结论引起输血不良反应的因素是多方面的,掌握不良反应发生的可能原因和规律,完善临床输血不良反应的预防监测体系,为输血安全提供保障。 展开更多
关键词 输血 不良反应 影响因素
Efficacy and safety of antifibrinolytic agents in spinal surgery: a network meta-analysis
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作者 Lei Yuan Yan Zeng +4 位作者 Zhong-Qiang Chen Xin-Ling Zhang Shuo Mai Pan Song Li-Yuan Tao 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第5期577-588,共12页
Background: Significant blood loss is still one of the most frequent complications in spinal surgery, which often necessitates blood transfusion. Massive perioperative blood loss and blood transfusion can create addit... Background: Significant blood loss is still one of the most frequent complications in spinal surgery, which often necessitates blood transfusion. Massive perioperative blood loss and blood transfusion can create additional risks. Aprotinin, tranexamic acid (TXA), and epsilon-aminocaproic acid (EACA) are antifibrinolytics currently offered as prophylactic agents to reduce surgery-ass oci a ted blood loss. The aim of this study was to evaluate the efficacy and safety of aprotinin, EACA, and low/high doses of TXA in spinal surgery, and assess the use of which agent is the most optimal intervention using the network meta-analysis (NMA) method. Methods: Five electronic databases were searched, including PubMed, Cochrane Library, ScienceDirect, Embase, and Web of Science, from the inception to March 1,2018. Trials that were randomized and compared results between TXA, EACA, and placebo were identified. The NMA was conducted with software R 3.3.2 and STATA 14.0. Results: Thirty randomized controlled trial (RCT) studies were analyzed. Aprotinin (standardized mean difference [SMD]=-0.65, 95% credibility intervals [CrI;-1.25,-0.06]), low-dose TXA (SMD=-0.58, 95% CrI [-0.92,-0.25]), and high-dose TXA (SMD =-0.70, 95% CrI [-1.04,-0.36]) were more effective than the respective placebos in reducing intraoperative blood loss. Low-dose TXA (SMD=-1.90, 95% CrI [-3.32,-0.48]) and high-dose TXA (SMD =-2.31, 95% CrI [-3.75,-0.87]) had less postoperative blood loss. Low-dose TXA (SMD=-1.07, 95% CrI [-1.82,-0.31]) and high-dose TXA (SMD =-1.07, 95% CrI[-1.82,-0.31]) significantly reduced total blood loss. However, only high-dose TXA (SMD =-2.07, 95% CrI [-3.26,-0.87]) was more effective in reducing the amount of transfusion, and was significantly superior to low-dose TXA in this regard (SMD =-1.67, 95% CrI [-3.20,-0.13]). Furthermore, aprotinin (odds ratio [OR]= 0.16, 95% CrI [0.05, 0.54]), EACA (OR = 0.46, 95% CrI [0.22, 0.97]) and high dose of TXA (OR = 0.34, 95% CrI [0.19, 0.58]) had a significant reduction in transfusion rates. An 展开更多
关键词 ANTIFIBRINOLYTICS SPINE surgery BLOOD LOSS TRANSFUSION Network META-ANALYSIS
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