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树立合理用血观念加强科学综合管理

庄俊玲

庄俊玲. 树立合理用血观念加强科学综合管理[J]. 协和医学杂志, 2015, 6(4): 275-277. doi: 10.3969/j.issn.1674-9081.2015.04.008
引用本文: 庄俊玲. 树立合理用血观念加强科学综合管理[J]. 协和医学杂志, 2015, 6(4): 275-277. doi: 10.3969/j.issn.1674-9081.2015.04.008

树立合理用血观念加强科学综合管理

doi: 10.3969/j.issn.1674-9081.2015.04.008
详细信息
    作者简介:

    庄俊玲:电话:010-69155027, E-mail:zhuangjunling@pumch.cn

  • 中图分类号: R457.1

  • 编者按:
    合理用血一直以来都是医疗机构关注的话题,蕴含着大学问。在2014年北京协和医院第六届“合理用血周”活动中,来自外科学系、内科学系、妇产科学系、麻醉科、急诊科、输血科的专家们作了14场精彩纷呈的合理用血学术讲座。通过分析用血现状,分享合理用血经验,直面用血中的问题和挑战,达成了坚守协和安全用血文化、保持多学科协作优势、遵循循证医学证据和用血指征、结合病种与个体化治疗、使患者最终获益的共识。现将讲者或科室撰写的部分研究成果以“合理用血专栏”形式予以发表。通过分享经验,以期达到持续推进合理用血、确保患者安全的目标
    输血是人类历史上重要的里程碑,临床输血历史已超过100年,大量患者的生命因输血而得以挽救;尤其是战争推动了输血的应用和发展,第一次世界大战期间开始冷藏血制品,二战期间美国红十字会成立。但输血在挽救生命的同时,其危害也逐渐受到重视,1943年报道输血传播肝炎,上世纪60年代越南战争期间接受输血的士兵发生了严重的急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS),更为严重的是1987年出现输血感染人类免疫缺陷病毒(human immunodeficiency virus,HIV)……而输血的风险还远远不止这些。
  • [1] The Society of Thoracic Surgeons Blood Conservation Guideline Task Force, Ferraris VA, Ferraris SP, Saha SP, et al. Perioperative blood transfusion and blood conservation in cardiac surgery:the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists clinical practice guideline[J]. Ann Thorac Surg, 2007, 83(5 Suppl):S27-S86. http://www.providencehealthcare.org/anesthesia/documents/STS-Guidelines.pdf
    [2] Innerhofer P, Luz G, Spötl L, et al. Immunologic changes after transfusion of autologous or allogeneic buffy coat-poor versus white cell-reducedblood to patients undergoing arthroplasty. I. Proliferative T-cell responses and the balance of helper and suppressor T cells[J]. Transfusion, 1999, 39:1089-1096. doi:  10.1046/j.1537-2995.1999.39101089.x
    [3] 中华人民共和国国家卫生和计划生育委员会(原卫生部).关于印发《临床输血技术规范》的通知[S/OL]. (2000-06-02).http://www.nhfpc.gov.cn/mohyzs/s3589/200804/18676.shtml
    [4] Hovav T, Yedgar S, Manny N, et al. Alteration of red cell aggregability and shape during blood storage[J]. Transfusion, 1999, 39:277-281. doi:  10.1046/j.1537-2995.1999.39399219284.x
    [5] Murphy GJ, ReevesBC, Rogers CA, et al. Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery[J]. Circulation, 2007, 116:2544-2552. doi:  10.1161/CIRCULATIONAHA.107.698977
    [6] Koch CG, Li L, Sessler DI, et al. Duration of red-cell storage and complications after cardiac surgery[J].N Engl J Med, 2008, 358:1229-1239. doi:  10.1056/NEJMoa070403
    [7] American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies. Practice guidelines for perioperative blood transfusion and adjuvant therapies:an updated report by the American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies[J]. Anesthesiology, 2006, 105:198-208. doi:  10.1097/00000542-200607000-00030
    [8] Littlewood TJ, Bajetta E, Nortier JW, et al. Effects of epoetinalfa on hematologic parameters and quality of life in cancer patients receiving nonplatinum chemotherapy:results of a randomized, double-blind, placebo-controlled trial[J]. J Clin Oncol, 2001, 19:2865-2874. doi:  10.1200/JCO.2001.19.11.2865
    [9] Ludwig H, Crawford J, Osterborg A, et al. Pooled analysis of individual patient-level data from all randomized, double-blind, placebo-controlled trials of darbepoetinalfa in the treatment of patients with chemotherapy-induced anemia[J].J Clin Oncol, 2009, 27:2838-2847. doi:  10.1200/JCO.2008.19.1130
    [10] The Society of Thoracic Surgeons Blood Conservation Guideline Task Force, Ferraris VA, Brown JR, Despotis GJ, et al. 2011 Update to The Society of Thoracic Surgeons and the Society of cardiovascular anesthesiologists blood conservation clinical practice guidelines[J]. Ann Thorac Surg, 2011, 91:944-982. doi:  10.1016/j.athoracsur.2010.11.078
    [11] Anselmi A, Guinet P, Ruggieri VG, et al. Safety of recombinant factor VIIa in patients under extracorporeal membrane oxygenation[J/OL]. Eur J Cardiothorac Surg, (2015-04-23). doi: 10.1093/ejcts/ezv140.http://ejcts.oxfordjournals.org/content/early/2015/04/22/ejcts.ezv140.abstract.
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  • 被引次数: 0
出版历程
  • 收稿日期:  2015-06-01
  • 刊出日期:  2015-07-30

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