临床输血现状研究进展  

The Situation of Current Clinical Blood Transfusion

作　　者：王帅博[1] 林强[2] 

机构地区：[1]中国医科大学党政办公室,沈阳110122 [2]中国医科大学附属盛京医院,沈阳2110004

出　　处：《中国卫生标准管理》2015年第14期181-184,共4页China Health Standard Management

摘　　要：输血疗法并不是完全没有风险的。目前,在输血过程中通过血液传播艾滋病和肝炎的风险已经减少,但由于输血所带来的重要危害仍然存在。细菌性败血症是发达国家输血带来的最常见的危害,这种危害往往是比疾病本身更加严重,往往是致命的,所以,不必要的输血行为应当避免。当患者需要输血,医院应与患者之间签订输血协议,这些协议的严格执行会在一定程度上降低死亡率,改善与患者沟通和方便为患者提供足够的血液制品。医院更应该建立一只包括多学科参与的团队,为患者使用血液制剂制定指导方针。虽然新鲜冰冻血浆中红细胞和血小板的红细胞比率≥1:2,患者接受大量输血的死亡率会因此降低,但是还没有足够的证据来推荐特定的比率。研究发现重组活化因子VII在经过常规的治疗措施未能控制出血,但可以成为一个紧急的治疗方案,同时应当加强术前血容量与凝血功能的管理与治疗,减少术中自体血液的浪费。血液制品的贮存有一定的有效期,为了提高患者的预后应当在贮存血的有效期内尽量输注新鲜血液。Transfusion is not entirely without risk. At present,the risk of HIV and hepatitis during blood transfusion has been reduced,but there are important hazards because of blood transfusion,sepsis bacterial is the most common hazard during the blood transfusion in developed countries, this hazard is often more serious and fatal than the disease itself,therefore,unnecessary transfusions behavior should be avoided,when a patient needs blood transfusion,the hospital should sign an agreement between the patient and the hospital,the implementation of these agreements should be strict,it will reduce the mortality rate in a certain extent and improve communication with patients and facilitate the provision ofadequate blood products for the patients,hospital should establish a multidisciplinary team and guidelines for patients to use blood products. Although fresh frozen plasma and platelets in the RBC ratio of≥1：2,patients receiving massive transfusions of mortality will thus reduced, but there is not enough evidence to recommend a specific ratio,recombinant activated factor VII was found failed to control the bleeding after conventional treatments,but it can become an emergency treatment,at the same time we should strengthen the management and treatment of preoperative blood volume and blood coagulation,reduce waste intraoperative autologous blood,storage of blood products have a certain duration,we should use fresh blood in the stored blood of validity in order to improve the prognosis of patients.

关 键 词：输血管理 血液预警系统 输血相关传染病 围手术期 

分 类 号：R446[医药卫生—诊断学]