Bachir D, Bonnet-Gajdos M, Galacteros F
Policlinique Médecine interne, Hôpital Henri-Mondor, Créteil.
Presse Med. 1990 Oct 27;19(35):1627-31.
Transfusion is one of the fundamental treatments in complications of sickle cell anaemia, a disease with peculiar features requiring an appropriate transfusion policy. Owing to the higher risk of vascular occlusion it carries, simple blood transfusion is indicated only for acute anaemia and for the very rare long-term transfusion programmes. In patients with severe occlusive and/or septic accidents, the risk of decompensation makes it mandatory to promptly reduce the sickle cell concentration; this is achieved by exchange transfusion the modalities of which are described by the authors. General anaesthesia also requires exchange transfusion in volumes that depend on the risk incurred. Finally, some patients benefit from a long-term transfusion programme. Potentially repeatable transfusions imply the use of phenotypes and leucocyte-freed red cell concentrates as well as detection and prevention of viral infections transmitted by transfusion. This article summarizes the recommendations that can now be made concerning the use of perfusion in the management of sickle cell anaemia.
输血是镰状细胞贫血并发症的基本治疗方法之一，这种疾病具有特殊特征，需要适当的输血策略。由于输血存在较高的血管闭塞风险，单纯输血仅适用于急性贫血和极为罕见的长期输血方案。对于患有严重闭塞性和/或感染性事故的患者，失代偿风险使得必须迅速降低镰状细胞浓度；这通过换血疗法来实现，作者描述了其方式。全身麻醉也需要根据所承担的风险进行不同容量的换血。最后，一些患者受益于长期输血方案。可能需要重复输血意味着要使用血型分型和去除白细胞的红细胞浓缩物，以及检测和预防输血传播的病毒感染。本文总结了目前关于在镰状细胞贫血管理中使用输血的建议。
