我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

急诊输注未配血O型红细胞临床分析

《创伤外科杂志》[ISSN:/CN:]

期数:
2020年12期
页码:
910-914
栏目:
论著·临床研究
出版日期:
2020-12-20

文章信息/Info

Title:
Use of uncross-matched type O red blood cells transfusion in emergency department-a retrospective review
文章编号:
1009-4237(2020)12-0910-05
作者:
仇威富; 章桂喜; 张永顶; 卢开林; 林爱玲; 樊敬文
518053 广东 深圳,香港大学深圳医院急诊及创伤中心(仇威富,卢开林,林爱玲),胃肠外科及创伤中心(章桂喜,樊敬文), 输血科(张永项)
Author(s):
QIU Wei-fu1; ZHANG Gui-xi2; ZHANG Yong-ding3; LU Kai-lin1; LIN Ai-ling1; FAN King Man Joe2; 4
1.AED and Trauma Center of the University of Hong Kong-Shenzhen Hospital,Shenzhen,Guangdong 518053,China; 2.Surgery and Trauma Center,the University of Hong Kong-Shenzhen Hospital,Shenzhan Guangdong 518053,China; 3.Blood Bank of the University of Hong Kong-Shenzhen Hospital,Shenzhan Guangdong 518053,China; 4.Department of Surgery,The University of Hong Kong,Shenzhan Guangdong 518053,China
关键词:
急诊输血;  O型血;  配型;  失血性休克
分类号:
R 457.1
DOI:
10.3969/j.issn.1009-4237.2020.12.007
文献标识码:
A
摘要:
目的 分析急诊科需要紧急配血但未有交叉配血结果的危重患者,输注未配血O型红细胞(UORBC)的反应,为紧急情况下输注未配血O型血提供理论及实践支持。方法 回顾性分析2014年3月—2019年8月香港大学深圳医院急诊科接受UORBC输注35例患者的临床资料,所用血液来自急诊科卫星血库。比较输血前后患者的生命体征,观察有无急性溶血等不良反应,并分析患者治疗结局。结果 共计35例患者在急诊科接受UORBC输注,男性25例,女性10例; 年龄14～80岁,平均 42.9岁。失血性休克34例(97.1%)。创伤患者23例(65.7%),非创伤患者12例(34.3%); 其中消化道出血3例,肿瘤破裂出血5例,妇科相关疾病致子宫附件大出血3例,血液病伴极重度贫血1例。ABO血型检测结果:A型11例,B型9例,AB型4例,O型11例; 35例均为RH阳性。急诊抢救室输注UORBC量:2U 18例,3U 1例,4U 14例,6U 2例。所有患者未发现急性溶血等不良输血反应,输血后血压较输血前得到改善(P<0.05),但休克指数(SI)没有明显降低(P=0.10)。创伤患者输血后生命体征改善及预后不如非创伤患者(P<0.05)。结论 在急诊科设置卫星血库,可以迅速为患者提供胶体溶液。紧急情况下为失血性休克患者输注UORBC是有效且安全可行的; 创伤失血性休克患者输注UORBC效果低于非创伤休克患者,可能跟创伤导致的严重不可逆损伤有关。

参考文献/References

[1] Schwab CW,Shayne JP,Turner J. Immediate trauma resuscitation with type O uncrossmatched blood: a two-year prospective experience[J]. J Trauma,1986,26(10):897-902.
[2] 于学忠,郭树彬,杜铁宽,等.特殊情况下紧急输血专家共识[J]. 中国急救医学, 2013,33(6):481-483.
[3] Ball CG,Salomone JP,Shaz B,et al. Uncrossmatched blood transfusions for trauma patients in the emergency department: incidence,outcomes and recommendations[J]. Can J Surg,2011,54(2):111-115.
[4] Harris CT,Totten M,Davenport D,et al. Experience with uncrossmatched blood refrigerator in emergency department[J]. Trauma Surg,2018,3(1):184.
[5] Powell EK,Hinckley WR,Gottula A,et al. Shorter times to packed red blood cell transfusion are associated with decreased risk of death in traumatically injured patients[J]. J Trauma Acute Care Surg, 2016,81(3):458-462.
[6] Kang BH,Choi D,Cho J,et al. Efficacy of uncross-matched type o packed red blood cell transfusion to traumatic shock patients: a propensity score match study[J]. Korean Med Sci, 2017,32(12):2058-2063.
[7] New Zealand Blood Service.A guide to the clinical use of blood components,blood products and blood transfusion procedures in New Zealand[M]. Transfusion Medicine Handbook Third Edition,2016:101.
[8] Parimi N,Hu PF,Mackenzie CF,et al. Automated continuous vital signs predict use of uncrossed matched blood and massive transfusion following trauma[J]. J Trauma Acute Care Surg, 2016,80(6):897-906.
[9] Bahr TM,DuPont TL,Christensen TR,et al. Evaluating emergency-release blood transfusion of newborn infants at the Intermountain healthcare hospitals[J]. Transfusion,2019,59(10):3113-3119.
[10] Leeper CM,Yazer MH,Cladis FP,et al. Use of uncrossmatched cold-stored whole blood in injured children with hemorrhagic shock[J].JAMA Pediatric, 2018,172(5):491-492.
[11] Finn D,Dorrian A,Sheehy J,et al. Emergency uncross-matched blood transfusions in a tertiary neonatal unit[J]. Acta Pediatric, 2017,106(2):218-222.
[12] Mulay SB,Jaben EA,Johnson P,et al. Risks and adverse outcomes associated with emergency-release red blood cell transfusion[J]. Transfusion,2013,53(7):1416-1420.
[13] 高峰.临床输血与检验[M]. 2版.北京:人民卫生出版社,2007:71.
[14] Yazer MH,Waters JH,Spinella PC,et al. Use of Uncrossmatched erythrocytes in emergency bleeding situations[J]. Anesthesiology,2018,128(3):650-656.
[15] Day DL,Anzelon KM,Conde FA. Association of prehospital shock index and trauma bay uncrossmatched red blood cell transfusion with multiple transfusion[J]. Trauma Nursing,2016,23(2):89-95.
[16] Nunez TC,Dutton WD,May AK,et al. Emergency department blood transfusion predicts early massive transfusion and early blood component requirement[J]. Transfusion,2010,50(9):1914-1920.

备注/Memo

备注/Memo:
【通信作者】 樊敬文,E-mail:drjoefan@hku-szh.org
更新日期/Last Update: 2020-12-20