5.12地震伤员输血情况调查
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摘要
目的探讨地震等大型自然灾害时大量急性创伤输血的特点及应对措施。方法对5.12汶川地震期间收治地震伤员用血情况进行调查,对其住院期间输血情况(输血前检查、用血时间分布情况,输血总量、成分输血比例等)进行统计分析。结果2008年5月12～31日地震伤员输血人数61例,红细胞149.5U,血浆9600mL。输血前检查率100%。输血患者输血前血红蛋白(Hb)平均为85.86g/L,其中54例患者输血前的Hb<90g/L,7例患者输血前Hb>90g/L。灾后前10d共输血98U,占总输血量的65.6%。结论当地震等大型自然灾害突发时,伤员存在伤情重、数量多、入院时间集中、大量失血等特点,医院输血科应迅速大量备血,掌握输血指征合理用血。在条件允许的情况下,尽量进行红细胞输血。当特殊紧急情况得不到ABO同型血时,也可考虑采用ABO相容但非同型的血液输注。同时应注意保留输血前检查的标本,尽可能保存完整的相关资料,确保输血安全。
Objective To investigate the character of massive blood transfusion of patients suffering from acute trauma during big natural disasters such as earthquake,and to offer the countermeasures.Methods Retrospective analysis was performed on the data of blood transfusion of the wounded patients in the 5.12 Weichuan earthquake in our hospital,especially for the examination before blood transfusion,the time distribution of blood transfusion,the total amount of blood transfusion,the proportion of component blood transfusion and so on.Results Sixty-one wounded patients received blood transfusion from 12th May to 31th May,2008 in our hospital.The consumption of erythrocyte suspension and plasma preparation was 149.5 U and 9 600 mL respectively.The proportion of reasonable transfusion was 100%.The average level of Hb was 85.86 g/L before blood transfusion.Fifty-four patients had a lower Hb than 90 g/L,and 7 cases had a higher Hb than 90 g/L.The consumption of RBC suspension was 98 U in the first 10 days after earthquake,accounting for 65.6% of total blood consumption.Conclusion When a big natural disaster such as earthquake explodes,the wounded patients are characteristics of worse traumatic condition,larger number,localized admission time,and massive blood loss.Adequate blood supply ought to be ensured and blood indication ought to be controlled by Department of Blood Transfusion.RBC transfusion should be used as far as possible.In emergent condition without ABO homotypic blood,different type blood transfusion but ABO compatible is available.At the same time,we might pay more attention to preserve blood samples,consummate the data about patients so as to ensure blood transfusion safety.
Objective To investigate the character of massive blood transfusion of patients suffering from acute trauma during big natural disasters such as earthquake,and to offer the countermeasures.Methods Retrospective analysis was performed on the data of blood transfusion of the wounded patients in the 5.12 Weichuan earthquake in our hospital,especially for the examination before blood transfusion,the time distribution of blood transfusion,the total amount of blood transfusion,the proportion of component blood transfusion and so on.Results Sixty-one wounded patients received blood transfusion from 12th May to 31th May,2008 in our hospital.The consumption of erythrocyte suspension and plasma preparation was 149.5 U and 9 600 mL respectively.The proportion of reasonable transfusion was 100%.The average level of Hb was 85.86 g/L before blood transfusion.Fifty-four patients had a lower Hb than 90 g/L,and 7 cases had a higher Hb than 90 g/L.The consumption of RBC suspension was 98 U in the first 10 days after earthquake,accounting for 65.6% of total blood consumption.Conclusion When a big natural disaster such as earthquake explodes,the wounded patients are characteristics of worse traumatic condition,larger number,localized admission time,and massive blood loss.Adequate blood supply ought to be ensured and blood indication ought to be controlled by Department of Blood Transfusion.RBC transfusion should be used as far as possible.In emergent condition without ABO homotypic blood,different type blood transfusion but ABO compatible is available.At the same time,we might pay more attention to preserve blood samples,consummate the data about patients so as to ensure blood transfusion safety.
引文
[1]Se hul man CI,Cohn SM.Transfusionin surgery and trau-ma[J].Crit Care Clin,2004,20:281-297.
[2]Carson JL,Poses RM,Spence RK,et al.Severity of ane-mia and operative mortality and morbidity[J].Lancet,1988,1:727-729.
[3]唐光生,李慧文,洪文,等.实用临床输血学[M].北京:中国科学技术出版社.2001.
[2]Carson JL,Poses RM,Spence RK,et al.Severity of ane-mia and operative mortality and morbidity[J].Lancet,1988,1:727-729.
[3]唐光生,李慧文,洪文,等.实用临床输血学[M].北京:中国科学技术出版社.2001.
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