深低温冻存脐血的回输及护理  

Salvage technique of cryopreserved umbilical cord blood and nursing experience

作　　者：吴云[1] 谯川南[1] 程洁慧[1] 洪梅[1] 

机构地区：[1]安徽医科大学附属安徽省立医院血液科,合肥230001

出　　处：《中国实用护理杂志（中旬版）》2010年第9期15-18,共4页Chinese Journal of Practical Nursing

基　　金：基金项目：安徽省临床医学技术应用项目（2008A011）;安徽省“十一五”科技攻关项目（06013128B）

摘　　要：目的探讨如何做好深低温冻存脐血的安全有效输注和护理。方法对78例患者111份脐血经不同输注途径回输过程中出现的不良反应进行观察及护理。结果静脉回输途径：67例中1例发生急性溶血反应；1例突发意识丧失，全身抽搐；4例发生剧烈头痛，伴呼吸困难、血压急剧升高；46例发生部分及不同程度的手脚、颜面部麻木，恶心呕吐，腹痛伴便意，呼吸困难伴胸部压迫感，血压升高，心率减慢或血压降低、心率加快，其中1例出现无症状性频发早搏；大部分病例出现回输后肉眼血红蛋白尿。骨髓腔注射回输途径：11例患者在注射过程仅发生局部及双下肢放射性酸胀，血红蛋白尿症状轻或无血红蛋白尿症状。78例患者111份脐血均成功输完，患者生命安全。结论静脉回输脐血不良反应以严重的全身反应为主，病情变化快且复杂，护理重点为充分预防准备，严密病情观察和积极有效对症处理；骨髓腔注射脐血不良反应以局部胀痛为主，护理重点为严格遵守无菌操作，掌握脐血注射时间。Objective To investigate the safety of infusion and effective care of cryopreserved um- bilical cord blood. Methods Side effects happened during transfusion of cord blood in 78 patients of 111 times Of transfusion were observed and nursed. Results During intravenous transfusion way：1 case with acute hemolytic reaction; 1 case with sudden loss of consciousness and convulsions; 4 cases with severe headache, difficulty with breathing, rapid increase of blood; 46 patients with high blood pressure, heart rate or blood pressure, heart rate, 1 patient had symptoms of frequent premature beats; most of the cases have hemoglobinuria after the infusion. Transfusion of bone marrow injection of ways： 11 patients have ra- dioactive soreness in leg,hemoglobinuria hemoglobinuria mild symptoms or no symptoms during the process of infusion. Conclusions Systemic reactions were the main side effects during intravenous transfusion of cord blood, conditions change fast and complex, Nursing should focus on preventive care and preparation, close observation and active and effective symptomatic treatment; reaction of bone marrow injection of umbilical cord blood was local pain, the focus of nursing was aseptic operation and injection time.

关 键 词：脐血干细胞移植 深低温冻存 骨髓腔内注射 护理 

分 类 号：R457[医药卫生—治疗学]