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输血原则及注意事项课件

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输血 原则 注意事项 课件
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Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 血型系统及血型 ABO血型系统及Rh血型系统 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 人的血型系统有多种 每一种血型系统对人 体的输血都有很大影响 其中以ABO血型系 统以及 Rh血型系统最为主要 ABO血型系统总共有四类血型 他们分别是 A型 B型 AB型 O型 Rh血型系统有两种 血型 分别是RBC表面含有D抗原的Rh阳性 血和不含D抗原的Rh阴性血 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 各 种 血 型 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial ABO血型的由来是根据RBC表 面所含特异性抗原不同而命名 的 例如 A型血代表RBC表 面含有A抗原 B型血含有B抗 原 O型血的RBC表面虽然不 含A B抗原 但是血清中却含 有抗A和抗B的免疫球蛋白 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial RB C 表 面 抗 原 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 血型的鉴定 正确鉴定血型是保证输血安全的基 础 血型的鉴定一般采用正向定型和反 向定型 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 常规的ABO定型必须包括正定型 即用抗A 抗B作红细胞 定型 和反定型 即用A及B细胞作血清定型 两种定型结 果可互相验证 使血型鉴定结果更为准确 在血型鉴定过程中 有许多因素可导致错误结果 有些 错误结果采用正定型不易发现 如标准血清问题 类B现 象 红细胞多凝或全凝集现象 某些原因的抗原减弱等 用反定型复查可弥补正定型的不足 在正反定型结果 出现不一致时 易于发现和纠正血型错误 正反定型对ABO亚型的发现有帮助 因为亚型病人红细胞 上抗原不易测出 易被误定 但其血清中多含有与其血 型相对应的抗体 所以反定型可以防止某些A B亚型漏 检 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 5 ABO血型 的鉴定 源于 A人 B人 O人 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial A型标准血清 抗B B型标准血清 抗A 模拟血型鉴定 血型 A B O AB Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 病人 A型标准 血清 B型标准 血清 血型 赵 钱 孙 李 请你来鉴定 B AB O A 凝集 凝集凝集 凝集 不凝集 不凝集 不凝集 不凝集 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 什么血型的人被称为 万能输血 者 O型 AB型 什么血型的人 万能受血者 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 血型的遗传 可以根据血型的遗传来做出亲 缘关系的鉴定 但是鉴定的最 终结果只能做出否的判定 而 不能做出肯定的判定 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 输血原则 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 正常生理状况下 身体的流血是可 以通过身体的自身调节修复机制 通过生理性止血完成 但是这只针 对于比较小的创伤 如果创伤面积 比较大 导致失血过多 就必须要 考虑输血 出血是输血的主要适应 证 特别是严重创伤和手术中出血 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 受伤严重 需要 立即输血 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 在什么情况下伤者才需要输血 如果一个人一次失血超过血液总量的 30 约1200毫升 以上 就会严重 影响人的生命活动 甚至危及生命 此 时就必须通过输血进行抢救 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 血液的来源 血液的采集是一个复杂的过程 涉及到 很多个环节 从起初的献血者开始到最 终的受血者 每一个环节都必须要严格 把关 不出任何错误 这样才能从真正 意义上做到安全输血 从而避免造成 RBC凝集及发生溶血 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 三 输血及其原则 1 输血原则 1 准备输血时先鉴定供血者与受血 者血型 2 血型相符的输血前也必须作交叉 配血检验 3 反复输血的受血者还要检测供血 者与受血者Rh血型 4 不同血型间输血只在紧急情况下 进行 但要注意输血量 速度及 受者的反应 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 输血一般采用同型输血 及A型 血输血者输A型血受血者 B型 血输血者输B型血受血者 但是 为了保证输血的安全性 在输血 之前 必须要进行交叉配血 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 3 交叉配血试验 主 次 同型 可输 主 次 异型 少输 慢输 主 次 异型 不可输 Cross match test Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial O O型 A AB BA型 AB型 B型输血关系图 输血原则 同血型输血 在危急情况下可以异血型输血 此时要考虑 供血者的红细胞中凝集原是否会与受血者血 清中凝集素发生反应 造成红细胞凝集 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 病人血型可接受 血型 不可接受 血型 赵B 钱AB 孙O 李A B OA AB AB A B O O A O 无 A AB B B AB Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial l交叉配血如果成功 就可以对 受血者进行输血 输血可以分为 全血输血和成分输血 种种理论 以及实验证明 成分输血比全血 输血有更多的益处 并逐渐将其 取代 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 成分输血 定义 就是把全血中的各种有效成分分离 出来 分别制成高浓度的制品 然后根据不 同患者的需要 输给相应制品 这是当前输血技术发展的总趋势 也是输 血现代化的重要标志之一 其特点为浓度高 针对性强 疗效好 不良 反应少 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 输血的注意事项 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 1 输血前检查 输血前必须仔细核对病人和供血者姓名 血 型和交叉配合血单 并检查血袋是否渗漏 血液颜色有无异常 除了生理盐水外 不可 向全血或浓缩红细胞内加入任何药物 以免 产生药物配伍禁忌或溶血 例如 加入葡萄 糖液 会使输血器内剩余的红细胞发生凝集 随之发生溶血 输血过程中要严密观察病 人有无不良反应 检查体温 脉搏 血压及 尿的颜色等 输血完毕后 血袋应保留2小 时 以便必要时进行化验复查 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 2 不输新鲜血 众多学者认为 输新鲜血 4天内 因其含有大量存活淋 巴细胞 增加发生移植物抗宿主病 TA GVHD 的危 险 Takahashi等总结了51例移植物抗宿主病病人 发现 在46例输注96小时的血液 其中38例输注的血液又24小 时 日本31例中29例 94 使用了新鲜血 惯用新鲜血 可能是日本高发病率的促发因素之一 而输3天以内的 血 还有传染梅毒的可能 因为梅毒螺旋体在体外4 可 生存48 72小时 目前 对新鲜全血缺乏公认的标准 主要根据输血的目的不同 新鲜全血的含义也不同 如果 输血的目的是纠正血液运氧能力不足和补充血容量 可用 保存期内任何一天的红细胞及血容量扩充剂就能满足 如 果输血的目的是为了补充血小板和粒细胞 则8 12小时 之内的离体血才算新鲜 但所含血小板和粒细胞不纯不浓 达不到治疗作用 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 3 不提倡亲属输血 输亲属的血发生输血相关的移植物抗宿主 病 TA GVHD 的可能性大 输血所致移 植物抗宿主反应 GVHR 发病快 疗效差 死亡率高达90 此病是输入含免疫活 性淋巴细胞 主要是T细胞 的血液 或成 分 后 淋巴细胞大量增殖 然后向宿主 发起攻击 导致宿主遭受严重病理损害甚 至死亡 这是一种致命的输血并发症 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 献血光荣
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