密闭式血浆回输方法在双重血浆置换中的应用研究  

Application research of closed autoplamotherapy method in double filtrated plasmapheresis

作　　者：徐玮 张静[1] 朱亚梅 杨家慧 马逊 王蓉花 Xu Wei Zhang Jing Zhu Yamei Yang Jiahui Ma Xun Wang Ronghua(Blood Purifying Center, the First Hospital Affiliated to Nanfing Medical University, Nanjing 210029, China)

机构地区：[1]南京医科大学第一附属医院血液净化中心,210029

出　　处：《中华现代护理杂志》2016年第25期3682-3684,共3页Chinese Journal of Modern Nursing

基　　金：国家临床重点专科建设基金资助项目（财社[2010]305号）;“十二五”国家科技支撑计划课题（2011BA110808）;江苏省临床医学科技专项（BL2014080）

摘　　要：目的：探讨双重膜滤过式血浆置换治疗结束时最佳的血浆回输方法。方法采用随机对照法将23例患者行56次双重血浆置换进行编号，按编号分为奇数次组和偶数次组，奇数次组采用常规回输血浆法；偶数次组采用生理盐水密闭回输血浆法。观察血浆分离器（一级滤器）、溢血浆、热源反应发生情况和血浆分离器（一级滤器）、血浆成分分离器（二级滤器）及管路内血浆残留量及操作所需时间。结果生理盐水回输血浆法热源反应发生率为0，空气输血浆法热源反应发生率为21.4％，差异有统计学意义（P〈0.05）；生理盐水回输血浆法溢血浆率为0，血浆残留量（5.47±1.35）ml，所需时间（10.91±0.53）min。空气回输血浆法溢血浆率32.1％，血浆残留量为（14.47±2.40）ml，所需时间（12.96±1.56）min；差异有统计学意义（ P〈0.01）。结论生理盐水回输血浆法安全，操作简单，降低了热源反应发生率和避免交叉感染，患者失血浆少，减少了工作人员血源性传播疾病的职业暴露，提高了工作效率。Objective To discuss the best autoplamotherapy method at the end of double filtrated plasmapheresis treatment. Methods A total of 23 patients who underwent 56 double plasmapheres were numbered according to randomized controlled method, and were divided into the odd-numbered group and the even-numbered group. The patients of odd-numbered group were given conventional autoplamotherapy method, while the patients of even-numbered group were given saline closed autoplamotherapy method. We observed the plasma separator （first level filter）, plasma overflow, heat reaction conditions, plasma separator （first level filter）, plasma component separator （second level filter）, the plasma inside the pipe, the remaining amount and time required for the operation.Results The heat reaction rates of saline autoplamotherapy method was 0, while air autoplamotherapy method was 21.4% （P〈0.05）; the plasma overflow rate of saline autoplamotherapy method was 0, and the residual amount of plasma was （5.47±1.35） ml, and the time required was （10.91± 0.53）min. For air autoplamotherapy method, the plasma overflow rate was 32.1%, and the residual amount of plasma was （14.47±2.40）ml, and the time required was （12.96±1.56）min; the difference was statistically significant （P〈0.01）.Conclusions Saline autoplamotherapy method is safe and easy to operate, and also can reduce heat reaction rates and avoid cross-infection. Patients lose less blood plasma which reduce the chance of occupational staff exposure to blood-borne diseases, and improve work efficiency.

关 键 词：双重血浆置换 密闭式回血 热源反应 职业暴露 

分 类 号：R473[医药卫生—护理学]