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从麻醉医生的视角看术前自体血采集的质量保证

[Quality assurance in preoperative autologous blood collection from the viewpoint of the anesthetist].

作者信息

Singbartl G, Schleinzer W

机构信息

Abteilung Anästhesiologie, Intensiv- und Transfusionsmedizin, ENDO-KLINIK, Hamburg.

出版信息

Beitr Infusionsther. 1993;31:193-201.

PMID:7693253
Abstract

From the anesthetist's point of view the following safety measures regarding autologous blood donation have to be considered: [1] inclusion/exclusion criteria for the patient's selection; [2] quality control of the autologous product itself and [3] adequate technical standards of the equipment applied. There is no doubt, the criteria used for the patient's selection of an autologous predeposit program have a great impact both on the number and the severity of complications that might occur. Anesthetists consider a patient eligible for an autologous predeposit program if he/she is considered eligible for an elective operative procedure, too; since this means that this patient demonstrates compensated organ functions (e.g. of the cardiovascular system, of the pulmonary function as well as of the metabolic and hematopoietic system). As shown by data in the literature, these criteria even hold true in patients with serious (but compensated) concomitant diseases. In contrast to the routine procedure of homologous donation, monitoring of a patient during the autologous predeposit procedure as well as an adequate replacement of the volume of the autologous predeposit donated appear to be reasonable, especially in patients with serious risk factors. Following this concept, the number of undesired side effects during the autologous donation is in the same order as it is known from healthy volunteers for homologous donation. It appears wise to apply the same safety and quality standards for an autologous predeposit as for the comparable homologous products. Most important and without any restriction, the autologous product has to be safe for the patient: there should be no bacterial contamination of the autologous product, and the corpuscular content of the autologous plasma should not exceed a definite limit.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

从麻醉医生的角度来看,必须考虑以下关于自体输血的安全措施:[1]患者选择的纳入/排除标准;[2]自体产品本身的质量控制;[3]所使用设备的适当技术标准。毫无疑问,用于患者自体预存式献血计划选择的标准,对可能发生的并发症的数量和严重程度都有很大影响。麻醉医生认为,如果一名患者也被认为适合进行择期手术,那么他/她就适合参加自体预存式献血计划;因为这意味着该患者的器官功能(如心血管系统、肺功能以及代谢和造血系统)处于代偿状态。文献数据表明,这些标准在患有严重(但代偿性)合并症的患者中同样适用。与异体献血的常规程序不同,在自体预存式献血过程中对患者进行监测以及对所捐献的自体预存血量进行适当补充似乎是合理的,尤其是对于有严重危险因素的患者。按照这个概念,自体献血过程中不良副作用的数量与健康志愿者异体献血时已知的数量处于同一水平。对自体预存式献血应用与可比异体产品相同的安全和质量标准似乎是明智的。最重要且毫无限制的是,自体产品必须对患者安全:自体产品不应有细菌污染,自体血浆的细胞成分不应超过一定限度。(摘要截选至250字)

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