【摘要】 目的 对市场上流通使用的血塞通注射液在溶血性方面的状况进行考察与研究。 方法 按《中国药典》2005年版一部附录ⅩⅧ B中药注射剂安全性检查法应用指导原则和中药、天然药物刺激性和溶血性研究的技术指导原则，对11 个厂家共计27 批血塞通注射液每批次样品制备4 个浓度，进行溶血实验研究，并采用分光光度法（545 λ/nm）测定计算溶血率，比较各批次样品的溶血率。 结果 不同厂家甚至同一厂家不同批次的血塞通注射液溶血率存在一定差异。 结论 在临床使用中应注意用量，过量使用可能导致溶血引起的不良反应；同时，应注意溶血引起的临床不良反应的观测。【Abstract】 Objective To explore the hemolysis of Xuesaitong injection. Methods According to the Guiding Principles of safety tests on traditional Chinese medicine injection in Annex ⅩⅧ B, Chinese Pharmacopoeia, 2005 Edition 1, and Technical Guidelines of studies on the irritability and hemolytic activity of traditional Chinese medicine and natural medicine, a total of 27 samples of Xuesaitong injections (each sample was diluted into four concentrations) produced by 11 manufacturers had been examined. Spectrophotometry (545 λ/nm) was used to calculate the hemolytic rate. Results There was a certain difference in the hemolytic rate among several samples of Xuesaitong injections produced by different manufacturers, or even different batches by the same manufacturer. Conclusion The dosage of Xuesaitong injections should be noted in clinical use. Excessive use may lead to adverse reactions caused by hemolysis; at the same time, clinical adverse reactions caused by hemolysis should be observed.
Hemolysis is one of the main complications associated with the use of ventricular assist devices. The primary factors influencing hemolysis include the shear stress and exposure time experienced by red blood cells. In addition, factors such as local negative pressure and temperature may also impact hemolysis. The different combinations of hemolysis prediction models and their empirical constants lead to significant variations in prediction results; compared to the power-law model, the OPO model better accounts for the complexity of turbulence. In terms of improving hemolytic performance, research has primarily focused on optimizing blood pump structures, such as adjustments to pump gaps, impellers, and guide vanes. A small number of scholars have studied hemolytic performance through control modes of blood pump speed and the selection of blood-compatible materials. This paper reviews the main factors influencing hemolysis, prediction methods, and improvement strategies for rotary blood pumps, which are currently the most widely used. It also discusses the limitations in current hemolysis research and provides an outlook on future research directions.
Abstract: Objective To summarize the clinical experience of plasma exchange （PE） during recardiopulmonary bypass (CPB) of patients with severe haemolysis in cardiac surgery. Methods Between January 2001 and December 2005, five patients required PE for severe haemolysis after cardiac surgery. There were periprosthetic leakage and infective endocarditis in 3 patients, congenital heart disease of pulmonary artery stenosis with unsatisfied right ventricular outflow tract patching in 1 patient and thrombosis during extracorporeal membrane oxygenation (ECMO) in 1 patient. They all need blood purification to avoid acute renal failure. Results Five patients were successfully treated with PE during CPB without major complications. The amount of plasma and blood transfused in the 5 patients were 2.2±0.8L and 0.6±0.3L respectively. The volume of plasma exchange and ultrafiltrate were 3.9±1.8L and 2.4±1.3L respectively.The electrolytes and bloodgas analysis in all patients were maintained at the normal levels. The hemodynamics was stable. After heart resuscitation CPB stopped smoothly. Disappearance of periprosthetic leakage and satisfaction of right ventricular outflow tract patching were observed by echocardiograms after peration.Extubation was performed 24h after the operation in 5 patients, and they were discharged 12 to 53 d after the operation with fully recovery. The urine was clear and the body temperature was normal. Before they left thehospital, the concentration of free hemoglobin was tested in 3 patients. The concentration of free hemoglobin was slightly higher in 1 patient (68mg/L), and normal in 2 patients (lt;40mg/L). Conclusion PE during CPB in severe haemolysis is a safe technique which can effectively prevent acute renal failure caused by severe mechanical haemolysis after cardiac surgery.
ObjectiveTo investigate the risk factors, prognostic factors and prognosis of Multidrug-Resistant Acinetobacter Baumannii (MDR-AB) infection of lower respiratory tract in Intensive Care Unit (ICU) of the Second Affiliated Hospital of Anhui Medical University. MethodsUsing retrospective analysis, we reviewed and compared clinical data of 77 AB infections in lower respiratory tract cases in ICU from January 2013 to March 2015. According to the resistance, patients were divided into a MDR-AB group and a NMDR-AB group. Then the risk factors, prognostic factors and prognosis of MDR-AB infection were analyzed. ResultsA total of 58 cases in the MDR-AB group, 19 cases in the NMDR-AB group were included. The result showed that, the MDR-AB infection in lower respiratory tract could significantly prolong the length of ICU stay (18.5±16.0 vs. 10.6±9.3 days, P<0.05) and increase the mortality (44.8% vs. 11.1%, P<0.01). Logistic regression analysis showed that the independent risk factors for MDR-AB infection in lower respiratory tract included Acute Physiology and Chronic Health Evaluation Ⅱ (Apache Ⅱ) score >15 (OR=0.138, 95%CI 0.03 to 0.625, P=0.01) and use of carbapenems (OR=0.066, 95%CI 0.012 to 0.0346, P=0.001). The independent prognostic factors included placement of drainage tube (OR=8.743, 95%CI 1.528 to 50.018, P=0.015) and use of vasoactive drugs (OR=12.227, 95%CI 2.817 to 53.074, P=0.001). ConclusionThe MDR-AB infection in lower respiratory tract can significantly prolong the length of ICU stay and increase the mortality. The Apache Ⅱ score >15 and use of carbapenems are the risk factors, and the placement of drainage tube and use of vasoactive drugs can increase the mortality of MDR-AB infection of lower respiratory tract in ICU.
【Abstract】 Objective To report 1 case of acute hemolytic anemia after liver transplantation because of ABO compatibility and therapeutic experience. Methods The patient with liver cancer underwent orthotopic piggyback liver transplantation on September 2010 after radiofrequency ablation of the tumors. The donor and recipient ABO blood types were type O and type A, separately. Acute hemolytic anemia occurred at 10 days after transplantation and hemoglobin decreased to 56 g/L. The bone marrow showed active hyperplasia; and myeboid∶erythroid was 0.52∶1. The immunosuppressants were used and type O washed red blood cells were transfused immediately. Results The general condition of the patient was improved; hemoglobin increased gradually and returned to 111 g/L at 34 days after liver transplantation. At 12 months of follow-up, hemoglobin was within normal range. Conclusion Using graft blood type washed red blood cells transfusion and immunosuppressants could be an effective therapeutic procedure in the patient with ABO compatility graft when acute hemolytic anemia occurrs.
Interventional micro-axial flow blood pump is widely used as an effective treatment for patients with cardiogenic shock. Hemolysis and coagulation are vital concerns in the clinical application of interventional micro-axial flow pumps. This paper reviewed hemolysis and coagulation models for micro-axial flow blood pumps. Firstly, the structural characteristics of commercial interventional micro-axial flow blood pumps and issues related to clinical applications were introduced. Then the basic mechanisms of hemolysis and coagulation were used to study the factors affecting erythrocyte damage and platelet activation in interventional micro-axial flow blood pumps, focusing on the current models of hemolysis and coagulation on different scales (macroscopic, mesoscopic, and microscopic). Since models at different scales have different perspectives on the study of hemolysis and coagulation, a comprehensive analysis combined with multi-scale models is required to fully consider the influence of complex factors of interventional pumps on hemolysis and coagulation.
目的:研究O型RhD阳性孕妇(其丈夫为非O型)血清IgG抗-A(抗-B)抗体效价与新生儿溶血病(HDN)的关系。方法:应用微柱凝胶技术对382例O型RhD阳性孕妇进行了免疫性IgG抗A(B)抗体效价检测及对其新生儿进行HDN(①新生儿ABO、Rh系统定型;②新生儿直抗实验;③游离IgG测定;④放散实验)的检测。结果:382例O型RhD阳性孕妇中IgG抗-A(B)效价lt;64者330例(占总数86.39%),抗体效价≥64者13.61%。其中发生HDN 5例,抗-A 3例,抗-B12例,总发生率1.31%.结论:夫妇血型不合应及时检测孕妇IgG抗体,随着孕妇体内IgG抗体效价的增高,新生儿ABO溶血病的发病率也随之升高。孕妇产前应定时进行IgG抗体检测,了解效价与新生儿溶血病发病率之问的关系,对于预防新生儿溶血病极为有效。