【摘要】：目的探討枸櫞酸鹽引起獻(xiàn)血者、受血者低血鈣不良反應(yīng)的防范措施。方法 997例單采血小板獻(xiàn)血者分為對(duì)照組和預(yù)防性口服鈣劑組,比較枸櫞酸鹽不良反應(yīng)發(fā)生率,分析預(yù)防性口服鈣劑組8例不良反應(yīng)誘因;統(tǒng)計(jì)2597例受血者枸櫞酸鹽不良反應(yīng)發(fā)生率,分析其中9例大量輸血患者血鈣和心電圖變化。結(jié)果單采血小板獻(xiàn)血者預(yù)防性口服鈣劑組不良反應(yīng)發(fā)生率1.25%(8/641),對(duì)照組4.78%(17/356),χ2=11.65,P0.01;預(yù)防性口服鈣劑組發(fā)生的8例不良反應(yīng)與抗凝劑比例、回輸血液速度、個(gè)體差異有關(guān);受血者枸櫞酸鹽不良反應(yīng)發(fā)生率(0/2 597);9例大量輸血患者血鈣濃度均減低[(0.38±0.21)mmol/L],心電圖未出現(xiàn)Q-T延長(zhǎng)。結(jié)論單采血小板獻(xiàn)血者在預(yù)防性口服鈣劑同時(shí),嚴(yán)格控制枸櫞酸鹽比例、回輸血液速度,可進(jìn)一步降低不良反應(yīng)發(fā)生率;大量輸血過(guò)程推薦血鈣監(jiān)測(cè)、心電監(jiān)護(hù)、凝血功能"三聯(lián)監(jiān)控"措施,血鈣監(jiān)測(cè)為敏感指標(biāo),對(duì)控制低血鈣不良反應(yīng)和鈣劑補(bǔ)充過(guò)量的高血鈣不良反應(yīng)具有重要意義。
[Abstract]:Objective to explore the preventive measures of hypocalcemia in blood donors and recipients caused by citrate. Methods 997 platelet donors were divided into two groups: control group and preventive oral calcium group. The incidence of adverse reactions of citrate was compared and the inducement of adverse reactions in preventive oral calcium group was analyzed. The incidence of adverse reactions of citrate in 2597 patients was analyzed and the changes of blood calcium and electrocardiogram in 9 of them were analyzed. Results the incidence of adverse reactions in the preventive oral calcium group was 1.25% (8 / 641) and that in the control group was 4.78% (17 / 356). 8 cases of adverse reactions occurred in preventive oral calcium group were related to the ratio of anticoagulant, blood transfusion speed, individual difference, and the incidence of citrate adverse reactions (0 / 2 597). In 9 patients with massive blood transfusion, serum calcium concentration was decreased [(0.38 鹵0.21) mmol/L], and Q-T prolongation was not observed in ECG. Conclusion the rate of adverse reactions can be further reduced by strictly controlling the ratio of citrate and blood transfusion rate in single platelet donors while taking prophylactic oral calcium at the same time. Blood calcium monitoring, ECG monitoring, blood coagulation function "triple monitoring" and monitoring of blood calcium are recommended as sensitive indexes in the course of blood transfusion. It is of great significance to control adverse reactions of hypocalcemia and excessive calcium supplementation.
【作者單位】： 濟(jì)源市中心血站;濟(jì)源市第二人民醫(yī)院;
【基金】：濟(jì)源市2015年度科技發(fā)展計(jì)劃項(xiàng)目(15013042)
【分類號(hào)】：R457.1

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