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血液及血液制品的使用。

Use of blood and blood products.

作者信息

Hunt E, Moore J S

机构信息

North Carolina State University College of Veterinary Medicine, Raleigh.

出版信息

Vet Clin North Am Food Anim Pract. 1990 Mar;6(1):133-47. doi: 10.1016/s0749-0720(15)30900-2.

Abstract

It is sometimes necessary for the practitioner to transfuse the ruminant with whole blood or plasma. These techniques are often difficult to perform in practice and are time-consuming, expensive, and stressful to the animal. Acute loss of 20-25% of the blood volume will result in marked clinical signs of anemia, including tachycardia and maniacal behavior. The PCV is only a useful tool with which to monitor acute blood loss after intravascular equilibration with other fluid compartments has occurred. An acutely developing PCV of 15% or less may require transfusion. Chronic anemia with PCV of 7-12% can be tolerated without transfusion if the animal is not stressed and no further decline in erythrocyte mass occurs. Seventy-five per cent of transfused bovine erythrocytes are destroyed within 48 hours of transfusion. A transfusion rate of 10-20 ml/kg, recipient weight, is necessary to result in any appreciable increase in PCV. A nonpregnant donor can contribute 10-15 ml of blood/kg body weight at 2-4 week intervals. Sodium citrate is an effective anticoagulant, but acid citrate dextrose should be used if blood is to be stored for more than a few hours. Blood should not be stored more than 2 weeks prior to administration. Heparin is an unsuitable anticoagulant because the quantity of heparin required for clot-free blood collection will lead to coagulation defects in the recipient. Blood crossmatching is only rarely performed in the ruminant. In field situations, it is advisable to inject 200 ml of donor blood into the adult recipient and wait 10 minutes. If no reaction occurs, the rest of the blood can probably be safely administered as long as volume overload problems do not develop. Adverse reactions are most commonly seen in very young animals or pregnant cattle. Signs of blood or plasma transfusion reaction include hiccoughing, tachycardia, tachypnea, sweating, muscle tremors, pruritus, salivation, cough, dyspnea, fever, lacrimation, hematuria, hemoglobinuria, collapse, apnea, and opisthotonos. Intravenous epinephrine HCl 1:1000 can be administered (0.2 to 0.5 ml) intravenously or (4 to 5 ml) intramuscularly if clinical signs are severe. Pretreatment with antipyretics and slowing the administration rate may decrease the febrile response. Blood or plasma administered too rapidly will also result in signs of cardiovascular overload, acute heart failure, and pulmonary hypertension and edema. Furosemide and slower administration of blood or plasma should alleviate this problem.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

有时从业者需要给反刍动物输注全血或血浆。这些技术在实际操作中往往很难实施,而且耗时、昂贵,还会给动物带来压力。急性失血达血容量的20% - 25%会导致明显的贫血临床症状,包括心动过速和狂躁行为。红细胞压积(PCV)只是在血管内与其他体液成分达到平衡后监测急性失血的一个有用工具。急性形成的PCV为15%或更低时可能需要输血。如果动物没有应激且红细胞量没有进一步下降,PCV为7% - 12%的慢性贫血可以不输血而耐受。75%的输注牛红细胞在输血后48小时内被破坏。要使PCV有任何明显升高,输血速度需达到10 - 20毫升/千克(受体体重)。非妊娠供体可以每隔2 - 4周按10 - 15毫升/千克体重的量献血。柠檬酸钠是一种有效的抗凝剂,但如果血液要储存超过几个小时,则应使用酸性枸橼酸盐葡萄糖溶液。输血前血液储存不应超过2周。肝素不是合适的抗凝剂,因为为采集无凝血血液所需的肝素量会导致受体出现凝血缺陷。反刍动物很少进行血液交叉配型。在野外情况下,建议给成年受体注射200毫升供体血液,等待10分钟。如果没有反应,只要不出现容量过载问题,其余的血液可能可以安全输注。不良反应最常见于非常年幼的动物或怀孕母牛。血液或血浆输血反应的症状包括打嗝、心动过速、呼吸急促、出汗、肌肉震颤、瘙痒、流涎、咳嗽、呼吸困难、发热、流泪、血尿、血红蛋白尿、虚脱、呼吸暂停和角弓反张。如果临床症状严重,可静脉注射1:1000的盐酸肾上腺素(0.2至0.5毫升)或肌肉注射(4至5毫升)。用退烧药预处理并减慢给药速度可能会降低发热反应。血液或血浆输注过快也会导致心血管过载、急性心力衰竭以及肺动脉高压和水肿的症状。使用速尿并减慢血液或血浆的输注速度应可缓解此问题。(摘要截断于400字)

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