摘要
目的考察输血输液加温仪应用于单采血小板血液回输过程中的安全性、有效性并评估相关护理操作。方法统计冬季单采血小板时的血液回输速度,统计血液在回血管路中经过的时间,用输血输液加温仪在不同温度设置下对离体血液加温,记录血液温度的上升速度,于0、15、30 min对血液标本进行血常规、游离血红蛋白以及红细胞形态学检验;冬季单采血小板过程中,对观察组与对照组献血者测量耳内与回血针头附近皮肤温度,观察献血者有无寒颤以及手臂发凉、疼痛或其他不适,献血结束后进行热舒适度评定。结果将输血输液加温仪分别设置为41、42、43℃,加温0、15、30 min后离体血液的血常规和血浆游离血红蛋白检测结果对比无差异(P>0.05),未发现红细胞形态学改变;在冬季不使用输血输液加温仪的情况下,采血开始后回血针头附近皮肤温度与采血开始之前有差异(P<0.05),观察组的所有部位采血开始之后的温度与采血开始之前对比均无差异(P>0.05);离体血液加温实验显示,当室温22~24℃,血液回输速度为(100~120)mL/min,应用血液加温仪可以使27℃左右的回输血液升温到33~37℃;应用加温仪的献血者感觉舒适和非常舒适的比例以及热舒适度的评分均高于对照组(P<0.05);加温仪的温度设置在38℃以上时,献血者热舒适度评分的平均值均在8以上。结论把输血输液加温仪应用到冬季单采血小板中是安全的,可以明显提高献血者的舒适度,体现血站的人性化服务,值得推广。
Objective To study the safety,effectiveness and nursing of blood/fluid warmer during the process of plateletpheresis in winter.Methods The blood re-transfusion speed during plateletpheresis in winter and the time of blood passing through the blood return pipeline was counted.The vitro blood was heated with a blood/fluid warmer under different temperature settings,and the rising speed of blood temperature was recorded.The blood samples were tested for blood routine examination,free Hb and erythrocyte morphology at 0,15 and 30 minutes.In the process of plateletpheresis in winter,the blood donors′ear temperature and the skin temperature near the reinfusion needle in the observation group and the controls were measured,and the blood donors were observed for shivering,arm chills,pain or other discomfort.After the blood donation,the thermal comfort was evaluated.Results There was no difference in the results of routine blood test and plasma free Hb test of vitro blood after warming at 41℃,42℃and 43℃for 0,15 and 30 minutes(P>0.05),and no change in erythrocyte morphology was found.The skin temperature near the reinfusion needle(before vs.after the start of phlebotomy)was statistically different by applying blood/fluid warmer or not(P<0.05),and no difference in the temperature between the start and end of phlebotomy was observed in the observation group(P>0.05).The vitro blood heating experiment showed that when the room temperature was within 22~24℃,the blood retransfusion speed was(100-120)mL/min;after the application of blood/fluid warmer,the temperature of reinfusion blood could be raised from 27℃to 33~37℃.The proportion of feeling comfortable and very comfortable and the score of thermal comfort in the blood donors who used the warmer were higher than those in the controls(P<0.05).When the temperature of the warmer was set above 38℃,the average score of thermal comfort of blood donors was above 8.Conclusion It is safe to apply the blood/fluid warmer during the plateletsapheresis in winter,which can significantly improve the comfort of blood donors and reflect the humanized service of blood stations,and is worth popularizing.
作者
莫心南
梁映媚
胡钻平
郭建生
钟炽辉
叶柱江
陈少彬
揭小梅
MO Xinnan;LIANG Yingmei;HU Zuanping;GUO Jiansheng;ZHONG Chihui;YE Zhujiang;CHEN Shaobin;JIE Xiaomei(Dongguan Central Blood Station,Dongguan 523000,China)
出处
《中国输血杂志》
CAS
2023年第2期188-193,共6页
Chinese Journal of Blood Transfusion
基金
2021年东莞市社会发展科技面上项目(20211800902212)。
