Share the patient is not reasonable use risk?

Science times

        In a blood transfusion is still not able to put an end to the security hidden danger of today, the public should be to choose the way science is a blood transfusion idea the thoroughly change. Component transfusion is a reliable choice, because blood transfusion process "a composition, means more points dangerous." Even in some experts to eyes, composition of the value is beyond all blood blood, let its advantage loss to danger.

        Our newspaper reporter liu-apprentice

        From the 1960 s American scientists put forward the concept of blood transfusion ingredients so far, composition with its blood transfusions save source, targeted, more security and other characteristics, in our country have a degree of clinical popularity.

        However, as the main measures of blood for clinical use, including the composition of autologous blood transfusion, blood transfusion and reasonable blood transfusion of blood, scientific way, in the application process in still affected by concept awareness deviation and improper operation and other factors of distress, cause excessive infusion of red blood cells, "comfort blood", abuse and plasma frequently occurred.

        Surgical patients do not reasonable blood use, part of the medical personnel blood transfusions save lack of professional knowledge, as a scientific phenomenon is difficult to stop blood direct reasons, and then amplified the our country hospital in all kinds of risk transfusion link.

        All frequent "blood shortage", and neither is the relationship.

        "Fragile" whole blood

        The shandong province zibo a hospital ever happened case together. Hospital emergency disposal in a trauma bleeding person, but found that the blood bank not whole blood, blood only ingredients, and lose all the blood must advance booking. The doctor to lose all the blood, chop is 3 days, watched the patient's life razorsharply.

        This event and then had sparked controversy. That part of doctors, patients lose is the blood, you should take whole blood, blood is not appropriate input composition.

        "In fact they did not understand the blood of various components of the role. This main between clinicians to blood transfusion knowledge update caused by not in time." Memories of a few years ago this case, the people's liberation army general hospital, have a deep WangDeQing, director of blood transfusion. He also to our reporter says, now the situation should be little little, although still has to avoid individual doctors to blood components there don't understand.

        In fact, from October 1998 China formally implement since basis, component transfusion in the clinical setting has won wide recognition. After a survey revealed that, Beijing's 3 armour hospital, 99.8% of all the blood transfusion ingredients, only a handful of patients need to lose all the blood therapy. The price of blood components although common above the blood, but because it can accord with the actual needs of by blood, and to reduce blood transfusions during the process of safety problems.

        The main ingredient in whole blood red blood cells, including plasma, platelets and clotting factors. According to different preservation condition, clotting factors will soon lost. "For the average bleeding patient, input the platelet; in view of the patients with anemia, can lose red blood cells. If we lose platelets and plasma, not only waste of resources, but also increase the blood by the blood of the burden." WangDeQing said.

        According to "blood stations" basic standards of the rules, from the blood of the preservation of time perspective, ACD and CPD (two anticoagulant save liquid formula English abbreviations) anticoagulation collection of whole blood and various kinds of red blood cells liquid storage life only for 21 days. That is, in all the blood of the preservation of a very short time, a lot of blood coagulation factor, white blood cells, platelets in gradually lost, and therefore can not be called it on real significance of whole blood.

        According to introducing, if blood after various ingredients in the separation, only red blood cells can be kept 35 days, plasma through the frozen can save for one year. According to the different time, the composition, characteristic set different storage condition, can save the maximum in the blood of the various components activity, better patients.

        "Blood is a scarce resource, if not making full use of, that will be a great pity." WangDeQing said.

        Component transfusion

        In 2007, sun yat-sen university hospital affiliated first successful rescue a total amount of blood loss is as high as 30000 ml of maternal age. In the process of operation due to the inability to blood coagulation, the surgeon rely on filling the gauze for maternal bleeding. However, a wound has just been plugging, another place wound and take blood. The doctor will stop bleeding gauze kept fill in the pelvic cavity, until the whole pelvic was gauze women fill.

        A clinical physicians believed that, component transfusion treatment may apply only to blood, and similar massive hemorrhage in the example above, must use whole blood to sustain the patient life.

        In the clinical treatment, 30000 ml of blood transfusion amount is very rare. WangDeQing said: "although mothers at that time lost in the blood types have not learned that, but face a lot of blood of the patients, and that as long as the (blood transfusion) component mix well, the same can play a good role. This need a doctor should master knowledge of blood transfusion dose."

        A large number of blood transfusion in time rapidly is an important means to sustain life. But large often leads to a blood transfusion coagulant function obstacle, the mortality rate as high as 40% ~ 75%. So, for a lot of blood transfusion coagulant function in patients with timely, accurate evaluation, and implement preventive collocation blood transfusions, to the success of the rescue is very important.

        The PLA three? øÎ six hospital inspection department directors JingHua think blood transfusions, in addition to aplastic anemia in patients with severe infection, according to situation when a blood transfusion with whole blood outside, other patients to treatment should be all adopt the component blood. JingHua to massive hemorrhage patients must use whole blood to sustain the life point of view is not totally agree.

        "Some postoperative hemorrhage patients, if is diffuse intravascular coagulation patients, losing complete blood negative effect instead." JingHua told the reporter.

        According to his introduction, if emergency operation patients suddenly in massive hemorrhage, from a blood transfusion families receive notice to the deployment good composition blood sent to the operating table, through the green channel need only 20 minutes. At that time, the operating room doctors need to suspend operation, mainly for the patient to stop bleeding.

        "Never for the blood don't deserve the delay of rescue, this kind of situation is unlikely to appear." JingHua said, usually in preoperative with surgery will be ahead of autologous blood for blood or patients for emergency preparations, the situation will only occur in emergency rescue and emergencies.

        Blood source safety

        In the PLA general hospital, blood transfusion in machine room, the reporter sees two full-automatic blood cells separator is running, a donor is working with a blood transfusion. "This machine is dedicated to a single acquisition composition of blood, for example, need only acquisition platelets, machine will the blood red blood cells, plasma and other ingredients to loss to the donor." WangDeQing introduction.

        The reporter understands, this equipment per the price was about 500000 yuan, existing in hospital, such as blood stations is a unit of blood, CaiXieChe, blood donation house with hard commonly.

        At present, the composition of the blood collection there are two major kinds of ways, that is the sampling whole blood will again after blood composition separation, and use directly in individual acquisition machine. If using a single collection technology, just a blood donors to whole blood collection in traditional ways 10 provided single component blood donors.

        WangDeQing to reporters: "such as need a unit of whole blood platelet, by way of need 10 donor; and provide single collection technology just a donor can meet. Also, a single acquisition to the composition of blood in quantity and quality can get good protection."

        At the same time, if the blood the ingredients in isolated, not only need the processing time, and many of the donor blood composition mixed together, virtually increased blood by the risk of infection.

        Blood collection after the completion of the work, must also be on the quality of blood testing. JingHua told reporters, in larger center blood stations, general respectively by means of imported reagent and domestic reagent, AIDS, syphilis, hepatitis b, c and various rules must be testing depressing the index, testing two times. Detection of any kind of reagents test appears unusual, blood will be scrapped problems to ensure security.

        In addition to the above five regular testing index, collection of fresh blood may have some other the parasite, if use directly, it will directly to infect by blood donors. And in cold storage after period of time, can will kill parasite, blood products instead of safety was improved.

        "Little lose" principle

        When a reporter asked about component blood separation will technology in remote parts of the blood stations difficult to achieve, WangDeQing don't think exists the chances, because "the technology is simple."

        Although the composition of all blood transfusion of blood transfusions above 90%, but there are still need to lose all the blood of individual cases. For example some more rare blood, blood stations don't take it to separation, direct the whole blood reserves. U.S. troops WALKING BLOOD BANK (mobile BLOOD BANK), the war of the BLOOD supply of soldiers to prepare for the screening, once encounter need a BLOOD transfusion, these special soldiers can provide fresh BLOOD source.

        "These soldiers both combat ability, and can solve difficult to carry blood and long time preservation problem, is worth our using for reference." WangDeQing said.

        Component transfusion technology in the process of popularization had was great resistance. However, after a lot of practice, was proved to be able to achieve maximum blood the effective utilization of the resources of important ways.

        The experiment shows that the bleeding when a blood transfusion, first crystalloid, colloid liquid, again lose blood components, lose the whole blood than direct effect is more significant. Data and facts also tell people, the risk of losing complete blood than lose a greater risk of blood components.

        "Many a composition, means more points to composition blood transfusion danger. Now the propaganda, cause everyone to the composition is not enough blood transfusions also some mistake." Experts in accepting our newspaper reporter to interview said.

        Component transfusion can solve the clinical transfusion most of the problems facing, especially in the treatment of blood areas, composition more dependent on blood, but blood transfusion does not have absolute safety. In our country, because the cause of the fund investment, there are dozens of known to the spread of the disease through the blood, and the medical field cannot be penetrated disease, cannot source from the blood screening, the disease of the window period it is also the transfusion safety major field of difficulty.

        "And component transfusion, lose the whole blood than superiority has disappeared." JingHua said.

        "In fact we everyday is a fear to everyone a blood transfusion, although in the control is very strict, but still have to control the factors. Transfusion safety if like a bucket, and those who are not controllable factors is the bucket short board." In secure blood use, WangDeQing stressed: "can not lose, don't lose; can lose, much less to lose; must lose, then lose autologous blood."

        Data shows, the hospital every year in China YongXieLiang increasing by 10%, in 2010 YongXieLiang reached more than 4000 tons. Although unable to get the domestic more comprehensive digital, but due to the use of non-standard cause disease risk and accident is not rare.

        When a large blood loss and severe anaemia affects vital signs are stable, blood transfusion is rescue; When a small blood loss or a mild anemia, vital signs are stable, blood transfusions might harm them. So far, for a blood transfusion infectious diseases and bring the risk of abnormal immune will not be able to avoid.

        Thus, a blood transfusion be a double-edged sword: save and harm a person, all in a "read" between.