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心脏直视手术后乙型肝炎的发病率:一项为期三年(1974 - 1976年)的回顾性研究。

Frequency of hepatitis B after open heart surgery: a retrospective study over a three-year period (1974--1976).

作者信息

Stute R, Krian A, Staudacher B, Schulte H D, Brüster H

出版信息

Thorac Cardiovasc Surg. 1979 Aug;27(4):238-40. doi: 10.1055/s-0028-1096252.

Abstract

In spite of intensive efforts to reduce the risk of hepatitis B after heart operations, this complication is observed in 40 % or more of the cases. Over a period of three years (1974--1976) we examined 588 patients who had undergone open heart surgery. The following results were found: In 1974 the hepatitis frequency was 2.0 %, while in 1975 and 1976 it was 0.6 % hepatitis B and 0.6 % non-B hepatitis. We believe the reason for this improvement is a more careful selection of blood donors and their continuous control according to the following parameters: regular clinical observation; regular chest x-ray; determination of BSR, hemoglobin and aminotransferase; TPHA test; and search for antibodies. In 1974 hepatitis-B-surface-antigen (HBsAg) was detected by means of reverse hemagglutination tests. Since 1975 a modified radioimmunoassay has been used for this purpose. No donor blood with abnormal results was transfused, except for a very small number of extreme emergencies. The good results demonstrated can only be obtained by following the described program and by strictly avoiding pool preparations.

摘要

尽管为降低心脏手术后感染乙肝的风险付出了巨大努力,但这种并发症仍在40%或更多的病例中出现。在三年时间(1974 - 1976年)里,我们检查了588例接受心脏直视手术的患者。结果如下:1974年肝炎发生率为2.0%,而1975年和1976年乙肝发生率为0.6%,非乙肝型肝炎发生率为0.6%。我们认为这种改善的原因是对献血者进行了更严格的筛选,并根据以下参数对他们进行持续监测:定期临床观察;定期胸部X光检查;测定血沉、血红蛋白和转氨酶;梅毒血清试验;以及检测抗体。1974年通过反向血凝试验检测乙肝表面抗原(HBsAg)。自1975年起,为此目的采用了改良的放射免疫测定法。除极少数极端紧急情况外,未输注结果异常的供血者血液。只有遵循上述方案并严格避免使用混合制剂,才能取得如此良好的结果。

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