红细胞输血在临床实践中的应用
Harvey G Klein1, Donat R Spahn, Jeffrey L Carson
1Department of Transfusion Medicine, National Institutes of Health, Bethesda, Maryland 20892, USA. hklein@mail.cc.nih.gov
Lancet (London, England)
|August 7, 2007
概括
红细胞 (RBC) 输血对于恢复氧化至关重要,但触发因素尚不清楚. 研究旨在开发更好的对输血需求的测定方法,并了解储存损伤的影响.
科学领域:
- 血液学 血液学 血液学
- 输血医学 输血医学
- 生理学 生理学 生理学
背景情况:
- 红细胞 (RBC) 输血是组织氧化不足的关键治疗方法.
- 由于缺乏敏感的实验室分析,目前的输血触发器严重依赖临床判断.
- 红细胞储存损伤对输血疗效的影响尚不清楚.
研究的目的:
- 审查当前红细胞输血方面的理解和挑战.
- 强调需要改进的方法来确定输血的必要性.
- 讨论RBC储存损伤和安全问题带来的影响.
主要方法:
- 关于红细胞输血实践,储存病变和安全性的文献综述.
- 对组织缺氧目前的诊断局限性的分析.
- 检查病原体无活化技术和输血并发症.
主要成果:
- 红细胞输血是必不可少的,但触发因素是有争议的,通常基于临床经验.
- 现有的实验室测定缺乏敏感性,可重复性和易于使用,用于检测区域组织缺氧.
- 红细胞储存损伤的临床意义仍然不太清楚.
- 感染风险仍然存在,特别是在发展中国家,病原体灭活技术仍在开发中.
- 尽管存在并发症,但红细胞输血提供了有利的治疗指数.
结论:
- 需要客观的实验室测定来指导红细胞输血决策.
- 对红细胞储存损伤的进一步研究是必要的,以优化输血结果.
- 通过灭活病原体来提高血液安全性至关重要,尤其是在资源有限的环境中.
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