Barton J C
Semin Hematol. 1981 Apr;18(2):95-121.
The delivery of optimal transfusion therapy requires that the physician first have a thorough understanding of his patient's disease and prior transfusion history. Sometimes the need for blood product administration is more apparent than real. In the selection of necessary therapy, particular blood components, their volumes, and the timing of their administration should be carefully planned. The transfusion of whole blood, particularly as single-unit transfusions, is rarely indicated. Often forgotten, autotransfusion represents a means whereby many subjects who have repeated, unusual, or severe reactions may receive safe treatment. An appreciation of the frequency and manifestations of transfusion-related problems permits effective treatment of ongoing reactions. The prophylactic measures which should be taken against future reactions in most patients are specific, and are the responsibility of the clinician, based upon his bedside observations and laboratory studies. Problems should be discussed with either a hematologist, pathologist, or blood banking expert without hesitation. These guidelines help conserve a precious resource and assure that safe, effective, and economical transfusion therapy is available for all patients in need.
要提供最佳的输血治疗，医生首先需要全面了解患者的病情和既往输血史。有时，输血治疗的必要性看似明显，实则不然。在选择必要的治疗方法时，应仔细规划特定血液成分、其用量以及输注时间。很少需要输注全血，尤其是单次输注。常常被遗忘的是，自体输血是一种让许多有反复、异常或严重反应的患者能够接受安全治疗的方法。了解输血相关问题的发生频率和表现有助于对正在发生的反应进行有效治疗。对于大多数患者，针对未来反应应采取的预防措施是具体的，这是临床医生的责任，需基于其床边观察和实验室研究来确定。如有问题，应毫不犹豫地与血液科医生、病理学家或血库专家进行讨论。这些指导原则有助于节约这一宝贵资源，并确保所有有需要的患者都能获得安全、有效且经济的输血治疗。
