模拟野战条件下环境下应急采血的血液质量评价  

Quality control of emergency blood collection in coastal areas in summer

作　　者：王丹[1] 陈锦华[2] 曾毅彪 林秀妹[1] 邓小军[1] 

机构地区：[1]南京军区福州总医院输血科,福州医学硕士350025 [2]南京军区福州总医院统计室,福州350025

出　　处：《医学研究生学报》2014年第5期513-516,共4页Journal of Medical Postgraduates

摘　　要：目的 战时应急采血是紧急状况下伤员输血救治的一项重要措施.文中模拟野战高温高湿环境下应急采血,从细菌污染和红细胞质量两方面探讨和评价战时应急采血的血液质量. 方法 在献血屋内对70名献血员常规安尔碘消毒后采血70份作对照组,另在模拟野外环境下对70名献血员先从内至外全手臂内侧下2/3安尔碘擦拭2次后再常规2次安尔碘擦拭消毒后采血70份作为试验组.其中每组各50份用于制备浓缩血小板,并进行细菌培养;20份对照组血液采集后置2～6℃冰箱存放,1～2 h后分离出红细胞悬液;20份试验组血液长途海陆运输4h后分离出红细胞悬液.保存期内分别检测红细胞质量参数（红细胞ATP、细胞外液FHb、细胞外液K＋、棘形红细胞率）. 结果 2组共100份浓缩血小板细菌培养,均未检出细菌.随着储存时间的延长,2组红细胞ATP含量均下降,差异无统计学意义（P＞0.05）.2组红细胞细胞外液FHb浓度随贮存时间的延长而逐渐升高,试验组第34天FHb浓度[（1356.1 ±813.6）mg/L]明显高于对照组[（652.9 ±423.0） mg/L],差异有统计学意义（P＜0.01）.2组棘形红细胞率随贮存时间的延长而逐渐升高,试验组第34天棘形红细胞率[（49.4±9.9）％]明显高于对照组[（23.7±11.5）％],差异有统计学意义（P＜0.01）.采血第1天试验组细胞外液K＋浓度[（7.1 ±0.7）mmol/L]明显高于对照组[（4.3±1.6） mmol/L],差异有统计学意义（P＜0.05）,但随着时间变化,2组K＋浓度逐渐增高,变化趋势基本一致,差异无统计学意义（P＞0.05）. 结论 模拟野外条件下采血,通过增加消毒次数改善卫生条件,血液质量并未产生严重的质量问题,但受高温,山路、水路颠簸及长途运输的综合影响,血液应在血液贮存期（35d）内尽早使用.Objective To raise the capability of war-time blood support in modern wartime and solve the blood supply problems in the process of combat readiness,investigating the security of the blood collecting in emergency stimulating Fujian battle-field,by detecting bacteria and physiological parameters of RBCs.Methods Platelet concentrates were cultured from 100 units of whole blood,fifty units collected at blood centres in the street,another fifty units collected emergency at outdoor stimulating Fujian battle-field.The forty bags of RBCs were assessed,twenty bags collected at blood center,and preserved immediately at 2-6 ℃ and then separated the RBCs unit from the whole blood after 1-2 h,as control group,another twenty bags collected emergency at outdoor and separated after transported for about 4 h on sealand way,as experimental group（simulating field environment group）.Both groups blood were detected for red cell parameters including concentration of adenosine triphosphate （ATP）,free haemoglobin （FHb）,extracellular potassium（K ＋）,and presence of echinocytes before shelf life of RBCs during storage.Results All 100 units of PLT concentrates weren＇t found to be contaminated after culturing.The ATP contents in the RBCs units decreased with the preservation time prolonged.And the decrease rate was higher in experimental group than in control.The mean level of ATP was （1.78 ±0.22）xrnol/g in 34th day of storage.The presence of echinocytes and FHb contents increased during RBCs storage,and the increase rate were higher in experimental group than in control.In 34th day of storage,the mean presence of echinocytes and contents of FHb were （23.7 ± 11.5） % and （652.9 ± 423.0） mg/L in control group,vs （49.4 ± 9.9） % （P 〈 0.05） and （1 356.1 ± 813.6） mg/L（P 〈 0.01） in experimental group.Extracellular K＋ contents was no significant different between two groups in the left thirty-four days of storage.But at the first day of blood storage,extracellular K＋ contents in experim

关 键 词：血液采集 野战 血液质量 血液保存期 细菌污染 夏季 

分 类 号：R446.11[医药卫生—诊断学]