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恒河猴免疫预防的现状(作者译)

[The present state of prevention of rhesus immunisation (author's transl)].

作者信息

Chavinié J, Poissonnier M H

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1978 Apr;7(3 Pt 2):569-75.

PMID:81222
Abstract

Rhesus factor immunisation and its complications should disappear if the indications and the techniques for abolishing it are followed. The indications follow from the usual mechanism by which immunisation occurs. This is the passage of Rh positive fetal red blood cells into the maternal circulation where they are detected by Kleihauer's test. If in pregnancy uterine bleeding, of accidental trauma occur or if amniocentesis, versions, operations on the pregnant uterus are performed or intrauterine death occurs, the necessary preventive action has to be performed on a rhesus negative woman. When pregnancy comes to an end, be it because of delivery at term when every rhesus negative woman who has not been immunised has to be treated (if the infant is rhesus positive) so the same applies after spontaneous abortion, extra-uterine pregnancy and especially after therapeutic termination of pregnancy after which it is often forgotten. The technique is simple: Within 72 hours a dose of 85 micrograms of anti D globulin is enough if injected intravenously or intramuscularly. Sometimes this quantity has to be increased, however, when the Kleihauer test has shown that more than 5 ml of rhesus positive blood has passed into the maternal circulation, or if blood of the wrong group has been transfused. The dose to neutralise 1 ml of blood is 10 micrograms.

摘要

如果遵循消除恒河猴因子免疫及其并发症的指征和技术,这些情况应该会消失。指征源于免疫发生的通常机制。这是Rh阳性胎儿红细胞进入母体循环,在那里通过克列豪尔氏试验被检测到。如果在怀孕期间发生子宫出血、意外创伤,或者进行羊膜穿刺术、胎位倒转术、妊娠子宫手术或发生宫内死亡,必须对Rh阴性女性采取必要的预防措施。当妊娠结束时,无论是足月分娩(此时每个未免疫的Rh阴性女性都必须接受治疗(如果婴儿是Rh阳性)),还是自然流产、宫外孕后,尤其是治疗性终止妊娠后(之后这一点常常被遗忘),情况都是如此。技术很简单:如果静脉注射或肌肉注射,72小时内一剂85微克的抗D球蛋白就足够了。然而,当克列豪尔氏试验显示超过5毫升Rh阳性血液进入母体循环,或者输入了错误血型的血液时,有时必须增加这个剂量。中和1毫升血液的剂量是10微克。

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