枸橼酸盐引起献血者、受血者低血钙不良反应的防范措施探讨

发布时间：2018-11-13 07:31

【摘要】：目的探讨枸橼酸盐引起献血者、受血者低血钙不良反应的防范措施。方法 997例单采血小板献血者分为对照组和预防性口服钙剂组,比较枸橼酸盐不良反应发生率,分析预防性口服钙剂组8例不良反应诱因;统计2597例受血者枸橼酸盐不良反应发生率,分析其中9例大量输血患者血钙和心电图变化。结果单采血小板献血者预防性口服钙剂组不良反应发生率1.25%(8/641),对照组4.78%(17/356),χ2=11.65,P0.01;预防性口服钙剂组发生的8例不良反应与抗凝剂比例、回输血液速度、个体差异有关;受血者枸橼酸盐不良反应发生率(0/2 597);9例大量输血患者血钙浓度均减低[(0.38±0.21)mmol/L],心电图未出现Q-T延长。结论单采血小板献血者在预防性口服钙剂同时,严格控制枸橼酸盐比例、回输血液速度,可进一步降低不良反应发生率;大量输血过程推荐血钙监测、心电监护、凝血功能"三联监控"措施,血钙监测为敏感指标,对控制低血钙不良反应和钙剂补充过量的高血钙不良反应具有重要意义。
[Abstract]:Objective to explore the preventive measures of hypocalcemia in blood donors and recipients caused by citrate. Methods 997 platelet donors were divided into two groups: control group and preventive oral calcium group. The incidence of adverse reactions of citrate was compared and the inducement of adverse reactions in preventive oral calcium group was analyzed. The incidence of adverse reactions of citrate in 2597 patients was analyzed and the changes of blood calcium and electrocardiogram in 9 of them were analyzed. Results the incidence of adverse reactions in the preventive oral calcium group was 1.25% (8 / 641) and that in the control group was 4.78% (17 / 356). 8 cases of adverse reactions occurred in preventive oral calcium group were related to the ratio of anticoagulant, blood transfusion speed, individual difference, and the incidence of citrate adverse reactions (0 / 2 597). In 9 patients with massive blood transfusion, serum calcium concentration was decreased [(0.38 卤0.21) mmol/L], and Q-T prolongation was not observed in ECG. Conclusion the rate of adverse reactions can be further reduced by strictly controlling the ratio of citrate and blood transfusion rate in single platelet donors while taking prophylactic oral calcium at the same time. Blood calcium monitoring, ECG monitoring, blood coagulation function "triple monitoring" and monitoring of blood calcium are recommended as sensitive indexes in the course of blood transfusion. It is of great significance to control adverse reactions of hypocalcemia and excessive calcium supplementation.
【作者单位】：济源市中心血站;济源市第二人民医院;
【基金】：济源市2015年度科技发展计划项目(15013042)
【分类号】：R457.1

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