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[血液微滤。对由聚氨酯泡沫制成的输血过滤器截留的聚集体进行扫描电子显微镜研究]

[Blood microfiltration. Scanning electron microscopic study of the aggregates retained by a transfusion filter made of polyurethane foam].

作者信息

Guidon R, Awad J, Laperche Y

出版信息

Rev Fr Transfus Immunohematol. 1975 Dec;18(4):457-76. doi: 10.1016/s0338-4535(75)80032-8.

Abstract

Preliminary studies of the transfusion filter Bentley PF 127, a polyfilter type with a graded serie of diameters of microfenestration are reported. Dog blood has been used in all instances of the trial phase. Variations of the hematological factors as well as biochemical disparities have been examined and all deposits were assessed by means of scanning electron microscope. Amounts of deposits increased with the blood age. As far as banked dog blood develops less microaggregates during storage than human blood, the SEM pictures reported are a plea for banked blood microfiltration in any transfusion to human beings. The deposits which were trapped in the polyurethane foam, had previously passed through a screen filter with pore size slightly wider than the standard one (250 microns instead of 170 microns). Unfortunately the possibility of thrombus formation is serious as far as banked blood is rather fragile, and due to a slow flow rate, the time of blood contact with the filter is enough to allow thrombus development. However, the amounts of clots greatly increased with the age of the blood. The importance of filtration by adsorption was not very visible. The future of such a depth filter is questionable: should we prefer a transfusion screen filter with small pore size, the efficiently of which is determined by its pore size, and which traps the microaggregates by mechanical retention, or a depth filter which is supposed to retain the microaggregates regard less of the size but which could be very easily thrombus invaded and does not allow a suffisant blood flow rate for patients needing large amounts of blood in period of initial resuscitation? The debate is open but we should recognize that a screen filter with small pore size is widely used in the hospitals.

摘要

报道了对Bentley PF 127输血过滤器的初步研究,这是一种具有一系列不同直径微窗孔的聚滤器类型。在试验阶段的所有实例中均使用了狗血。已检查了血液学因素的变化以及生化差异,并通过扫描电子显微镜对所有沉积物进行了评估。沉积物的数量随血液保存时间增加。由于库存狗血在储存过程中形成的微聚集体比人血少,因此所报道的扫描电子显微镜图片表明,在对人类的任何输血中都应对库存血液进行微过滤。截留在聚氨酯泡沫中的沉积物先前已通过孔径略宽于标准孔径(250微米而非170微米)的筛网过滤器。不幸的是,由于库存血液相当脆弱,血栓形成的可能性很大,并且由于流速缓慢,血液与过滤器接触的时间足以使血栓形成。然而,凝块的数量随着血液保存时间的增加而大大增加。吸附过滤的重要性不太明显。这种深层过滤器的前景值得怀疑:我们是应该选择一种小孔径输血筛网过滤器,其效率由孔径决定,通过机械截留捕获微聚集体,还是选择一种深层过滤器,它应该能截留各种尺寸的微聚集体,但很容易被血栓侵入,并且对于在初始复苏阶段需要大量血液的患者而言,不能提供足够的血流速度?这场争论尚无定论,但我们应该认识到,小孔径筛网过滤器在医院中被广泛使用。

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