输液加温器在含冷凝集素患者输注血制品中的应用  

Application of infusion warmer in transfusion of blood products in patients with cold agglutinin

作　　者：吴成志 李仁杰 张宇亮 崔邦铨 董成林 徐灵 WU Cheng-zhi;LI Ren-jie;ZHANG Yu-liang;CUI Bang-quan;DONG Cheng-lin;XU Ling(Department of Clinical Laboratory,Shanghai MCC Hospital,Shanghai 200941,CHINA)

机构地区：[1]上海中冶医院检验科,上海200941

出　　处：《海南医学》2022年第8期987-989,共3页Hainan Medical Journal

基　　金：上海市宝山区医疗卫生计划项目(编号:2020096184)。

摘　　要：目的探讨输液加温器在含冷凝集素患者输注血制品中的应用效果。方法选取2017年1月至2020年8月于上海中冶医院输注血制品的94例含冷凝集素(效价为1:16~1:32)患者展开研究,采取随机奇偶数法分成对照组和研究组各47例。对照组患者室温下直接输注红细胞悬液,研究组患者采用输液加温器输注红细胞悬液。比较两组患者输注前、输注后24 h血清中的补体C3浓度及输注前、输注后30 min的体温变化,并分析两组患者输注过程中输注速度减慢、寒战、血压下降的发生情况。结果研究组患者输注前、输注后24 h血清中的补体C3浓度比较差异均无统计学意义(P>0.05),而输注后24 h,对照组患者血清中的补体C3浓度为(1.18±0.29)g/L,明显低于其输注前的(1.33±0.36)g/L和研究组输注后的(1.32±0.36)g/L,差异均有统计学意义(P<0.05);研究组患者输注前、输注后30 min的体温比较差异均无统计学意义(P>0.05),而输注后30 min,对照组患者的体温为(34.01±1.22)℃,明显低于其输注前的(35.64±0.77)℃和研究组输注后的(35.24±0.74)℃,差异均有统计学意义(P<0.05);研究组患者输注速度减慢、寒战、血压下降的发生率分别为0、4.26%、21.28%,明显低于对照组的36.17%、29.79%、40.43%,差异均有统计学意义(P<0.05)。结论含冷凝集素患者输注血制品时采用输液加温器的效果较好,不会对血清中的补体C3浓度产生影响,保持患者体温的同时,可以保证均匀的输注速度,且有效减少寒战、血压下降的发生。Objective To investigate the effect of infusion warmer in transfusion of blood products in patients with cold agglutinin.Methods A total of 94 patients with cold agglutinins(titer:1:16 to 1:32)who were transfused with blood products in Shanghai MCC Hospital from January 2017 to August 2020 were selected for study.They were divided into control group and study group by random odd-even method,with 47 patients in each group.Patients in the control group were directly transfused with red blood cell suspension at room temperature,while patients in the study group were transfused with red blood cell suspension by infusion warmer.The serum complement C3 concentration before and 24 h after infusion and the body temperature changes before and 30 min after infusion were compared between the two groups,and the occurrence of infusion speed slowdown,chills and blood pressure drop in the two groups during infusion was analyzed.Results There were no significant difference in serum C3 concentration before and 24 h after infusion in the study group(P>0.05);but 24 h after infusion,the serum C3 concentration in the control group was(1.18±0.29)g/L,which was significantly lower than(1.33±0.36)g/L before infusion in the control group and(1.32±0.36)g/L after infusion(P<0.05).There were no significant difference in body temperature before and 30 min after infusion in the study group(P>0.05).However,30 min after infusion,the body temperature in the control group was(34.01±1.22)℃,which was significantly lower than(35.64±0.77)℃before infusion in the control group and(35.24±0.74)℃after infusion in the study group(P<0.05).The incidence of infusion speed slowdown,chills,and blood pressure drop in the study group were 0,4.26%,and 21.28%,which were significantly lower than 36.17%,29.79%,and 40.43%in the control group(P<0.05).Conclusion The application of infusion warmer brings favorable effect in transfusion of blood products for patients with cold agglutinins,which will not affect the concentration of complement C3 in serum,and can

关 键 词：冷凝集素 输液加温器 输注 血制品 红细胞悬液 寒战 

分 类 号：R457.1[医药卫生—治疗学]