Catania G, Petralia G, Catalano F, Marzullo E
Dipartimento di Chirurgia, Università degli Studi di Catania.
G Chir. 1995 Mar;16(3):132-6.
Advances in surgery and the extension of the surgical indications have amplified the problems due to hemorrhage, main side effect, and its treatment, which in the past consisted primarily in whole blood transfusion. Such practice, however, involves the surgeon in a series of problems due to shortage of blood donors, religious beliefs and most of all the risks related to the transfusion practice itself. Apart from early and late reactions, the risk of transmission of infective diseases, post-transfusional immunodepression and legal problems must be pointed out. Recently, to solve these problems, the indications to blood transfusion have been restricted to severe hypovolemic shock and severe untreatable hypoxia; the separate use of blood components has been privileged; and autologous blood transfusion techniques like pre-deposit for donation, normovolemic preoperative hemodilution and intraoperative autologous transfusions have been used. It's mandatory that the surgeon keeps in date with the Transfusional Medicine progresses working in strict collaboration with the Transfusional Services to best protect the good health of the patients he has in care.
外科手术的进展以及手术适应证的扩展，放大了出血及其治疗所带来的问题，出血是主要的副作用，过去主要通过输注全血来治疗。然而，这种做法使外科医生面临一系列问题，包括供血者短缺、宗教信仰，最重要的是与输血操作本身相关的风险。除了早期和晚期反应外，还必须指出传染病传播的风险、输血后免疫抑制以及法律问题。最近，为了解决这些问题，输血适应证已局限于严重低血容量性休克和严重的无法治疗的低氧血症；优先单独使用血液成分；并且采用了自体输血技术，如术前预存式自体输血、等容性术前血液稀释和术中自体输血。外科医生必须与输血服务部门密切合作，及时了解输血医学的进展，以最好地保护其负责照料的患者的健康。
