摘要
目的探讨枸橼酸盐引起献血者、受血者低血钙不良反应的防范措施。方法 997例单采血小板献血者分为对照组和预防性口服钙剂组,比较枸橼酸盐不良反应发生率,分析预防性口服钙剂组8例不良反应诱因;统计2597例受血者枸橼酸盐不良反应发生率,分析其中9例大量输血患者血钙和心电图变化。结果单采血小板献血者预防性口服钙剂组不良反应发生率1.25%(8/641),对照组4.78%(17/356),χ2=11.65,P<0.01;预防性口服钙剂组发生的8例不良反应与抗凝剂比例、回输血液速度、个体差异有关;受血者枸橼酸盐不良反应发生率(0/2 597);9例大量输血患者血钙浓度均减低[(0.38±0.21)mmol/L],心电图未出现Q-T延长。结论单采血小板献血者在预防性口服钙剂同时,严格控制枸橼酸盐比例、回输血液速度,可进一步降低不良反应发生率;大量输血过程推荐血钙监测、心电监护、凝血功能"三联监控"措施,血钙监测为敏感指标,对控制低血钙不良反应和钙剂补充过量的高血钙不良反应具有重要意义。
Objective To explore measures to prevent the adverse reaction caused by citrate in blood donors and recipi- ents. Methods 997 apheresis platelets donors were divided into control group and treatment group （treat with preventive oral calcium）. The rates of adverse reaction caused by citrate in the two groups were compared and the cause of eight incidents in which adverse reaction occurred in treatment group were analyzed. Additionally, the adverse reaction rate in 2 597 recipients was estimated and blood calcium and ECG changes from 9 recipients who went through massive blood transfusion were analyzed. Results In the treatment group, the adverse reaction rate was 1.25% （8/641） and the rate in control group was 4.78% （ 17/356）, X^2 = 11.65, P 〈 0. 01. The eight incidents of adverse reaction in treatment group were associated with high anticoagulant concentration, rapid rate of autotransfusion and individual variation. In the recinient groun. the adverse reaction rate was 0 （0/2 597 ）. The blood calcium concentration found in the nine massive blood transfusion cases was reduced by （0. 38 ±0. 21 mmol/L）. No Q-T prolongation was observed in the ECG of nine patients. Conclusion The preventive oral calcium supplement can help reduce the adverse reaction rate within apheresis platelets donors, provided that citrate concentration and the rate of autotransfusion are strictly controlled. During massive blood transfusion, it is recommended to monitor blood calcium, ECG and blood coagulation symptoms （three-way monitoring）. Among these factors, blood calcium is the most sensitive index and plays an important role in controlling the adverse reactions caused by low or high blood calcium level.
出处
《中国输血杂志》
CAS
北大核心
2016年第10期1161-1164,共4页
Chinese Journal of Blood Transfusion
基金
济源市2015年度科技发展计划项目(15013042)
关键词
枸橼酸盐
不良反应
低血钙
三联监控
citrate
adverse reactions
low blood calcium
three-way monitoring
