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桡动脉采血后致右手背伸及曲腕功能障碍一例

130 例肺癌患者机采血小板输注疗效的分析

目的 分析肺癌患者机采血小板的输注情况，探讨其疗效的影响因素及预防措施。 方法 收集 2010 年 1 月—2016 年 6 月 130 例肺癌患者输注机采血小板 205 例次的临床资料，根据血小板纠正增加指数来评价输注的临床疗效。从疾病类型、性别、年龄、体质量、血小板输注次数以及红细胞悬液输注情况对患者血小板输注疗效进行分析。 结果 130 例肺癌患者 205 例次血小板输注中，158 例次有效，其有效率为 77.1%；小细胞肺癌和非小细胞肺癌有效率分别为 81.5% 和 75.5%，差异无统计学意义（P=0.369）；而非小细胞肺癌中的鳞状细胞癌和腺癌有效率分别为 82.3% 和 70.8%，差异无统计学意义（P=0.107）；不同性别、年龄和体质量有效率差异无统计学意义（P>0.05）；按血小板输注次数为第 1 次、第 2～4 次和第 4 次以上分组比较，有效率差异有统计学意义（P=0.022）。 结论 肺癌患者血小板输注次数可能是影响血小板输注疗效的因素，随着血小板输注次数的增加，发生血小板输注无效的可能性越大。

真空负压静脉采血的研究进展

【摘要】　真空负压静脉采血法，使血标本在采集、运输、保存环节处于全封闭状态，能最大限度保持血液标本的原始状态，保护医护人员免受职业伤害，可提高一次性采血成功率，是静脉血标本采集的一大改革。由于其具有使实验数据准确可靠、无污染、工作省时省力等优点，已被广泛使用。近年来，研究人员就真空负压采血的临床应用进行了大量的实践，对采血针的选择、压脉带的使用、穿刺技术及方法改进、采血质量控制、护理措施等进行了一系列研究。医务人员加强采血知识的学习可减少采血并发症，保证标本质量，减少医疗资源的浪费和减轻患者痛苦。

以顽固性低钾血症为首发症状的 MRI阴性库欣病一例

不同厂商紫头真空采血管的血常规结果比对

目的：对不同厂商的紫头真空采血管进行评估，其血常规结果是否有差异。方法：同时使用美国BD公司和成都瑞琦公司生产的紫头真空采血管采集40份新鲜全血标本，分别在自动血液分析仪XE-2100进行检测，再进行白细胞(WBC)、红细胞(RBC)、血红蛋白(HGB)、血小板(PLT)等参数的相关性比较。结果：WBC、RBC、HGB和PLT等参数的差异百分率分别为：0.49%、0.05%、0.13%和1.01%；相关系数(r)分别是：0.9985、0.9964、0.9966和0.9932；t检验的P值分别是：0.9706、0.9020、0.9679、0.9061，均gt;0.05。结论：真空采血管普遍应用于临床标本的采集，由于真空度、抗凝剂的量、管壁的质量对血常规结果均有影响，不同厂商的真空采血管质量不完全相同，通过新鲜全血的结果比对，美国BD公司和成都瑞琦公司生产的紫头真空采血管的血常规结果相关性好，其相关系数均在0.99以上，P值均gt;0.05，无显著性差异，差异百分率小，均lt;±2.0%的可接受范围，表明可用于临床。

静脉采血患者的情绪体验和心理测评及护理对策

目的了解采血患者的情绪体验和心理反应，为开展针对性心理护理提供参考。 方法随机抽取2012年3月1日-6月30日期间的438例门诊采血患者进行情绪体验问卷调查测评和症状自评量表（SCL-90）测试。 结果采血患者情绪体验得分从高到低分别为烦躁感（4.23±2.21）分，恐惧感（4.12±1.34）分，陌生感（3.78±1.23）分，疑虑感（3.56±1.42）分，焦虑感（3.07±1.18）分，无助感（1.76±0.93）分。女性患者在陌生感、恐惧感、焦虑感、无助感和疑虑感得分低于男性，差异有统计学意义（P＜0.05）。不同年龄段、不同职业、不同学历患者各类型情绪体验得分差异有统计学意义（P＜0.05）。SCL-90分值显示，其躯体化因子、强迫症状因子、抑郁因子、焦虑因子、敌对因子、恐惧因子明显高于国内常模，差异有统计学意义（P＜0.001）。 结论对静脉采血患者采取有针对性的心理护理，增强护患沟通和温馨服务，提高护理服务质量和管理水平，促进静脉采血患者的心理健康和就医体验，有利于病情康复。

Clinical study on blood sampling test of arteriovenous reversal in continuous renal replacement therapy

ObjectiveTo explore the feasibility of pipeline blood sampling test of continuous renal replacement therapy (CRRT) when arteriovenous reversal connection occurs, and to explore the influence of pipeline blood sampling test on the results of CRRT when arteriovenous reversal connection occurs under different anticoagulation methods.MethodsSelected patients with arteriovenous reversals treated by CRRT in a third-class A hospital was selected from June 2018 to May 2019. Blood samples were collected from the front end of the CRRT pipeline (0-, 3-, and 5-min after the cease). Blood samples collected from the catheterization site were compared with those from the body vein for acid and alkali, respectively. The electrolyte and other results were analyzed and compared.ResultsA total of 80 patients were enrolled, including 40 with low molecular weight heparin and non-heparin, and 40 with citric acid. Under the anticoagulation condition of low molecular weight heparin and non-heparin, there was no difference in acid-base or electrolyte between body venous blood samples and pipeline blood samples (P>0.05). Under the anticoagulation condition of citric acid, 0-, 3-, and 5-min after the cease, the difference in free calcium between body venous blood samples and pipeline blood samples was significant (F=7.866, 6.691, 5.590, P<0.001). There was no difference in other acid-base or electrolyte results (P>0.05).ConclusionsLow molecular weight heparin and heparin-free anticoagulation can be tested by collecting blood samples from the front end of the pipeline without suspension of treatment in the case of arteriovenous reversal in CRRT. There was a difference between free calcium and body venous blood in anticoagulation with citric acid. It is not recommended to collect blood from pipes for examination Under the anticoagulationcondition of citric acid.

心理干预在体检人员采血晕针中的应用

目的　在体检采血中对体检人员实施心理干预，有效解除体检人员的心理障碍，达到预防晕针的目的。 方法　选择2011年1月－6月行健康体检的33 372人（对照组），2011年7月－12月行健康体检的46 796人（干预组）进行比较分析。对照组采用常规体检服务程序方式，干预组采用灵活的个性化心理干预方法，观察两组体检人员采血时晕针发生率。 结果　对照组和干预组在接受采血时晕针发生率比较，干预组晕针发生率低于对照组，差异具有统计学意义（P＜0.05）。 结论　使用灵活的个性化心理干预方法对采血体检人员进行语言疏导，在注意力分散及松弛疗法的情况下完成采血过程，可降低体检人员晕针发生率， 值得临床推广。

真空采血管在老年难治性窦道伤口治疗中的应用

【摘要】　目的　总结真空采血管在老年难治性窦道伤口治疗中的应用效果。　方法　回顾性分析2009年12月—2010年9月收治因肾癌和神经源膀胱手术后4例老年难治性窦道伤口患者的病例资料，总结采用真空采血管进行伤口治疗的方法及疗效。　结果　患者经过12～14 d后伤口闭合，上皮覆盖，达到伤口全部愈合。　结论　采用真空采血管治疗老年难治性窦道伤口，方法简便，费用低廉，可有效促进伤口愈合。

Accidental Rupture of Balloon Tube during Endotracheal Intubation in Mechanical Ventilation: Clinical Application of No. 8 Blood Collection Needles for Connection

ObjectiveTo investigate the clinical effect of No. 8 blood collection needles in connecting broken balloon tubes. MethodsThirty-six patients who underwent mechanical ventilation in the Intensive Care Unit between January 2010 and December 2013 were included as the study subjects. We divided them into two groups. Patients who had accidental rupture of balloon tube during intubation were regarded as the trial group, while those with normal ventilation were regarded as the control group, with each group having 18 patients. The trial group used No. 8 disposable blood collection needles to connect the balloon tubes. Pressure gauge produced in Germany was used to measure the balloon pressure continuously for four hours. Balloon pressure level, balloon leakage and tube dislocation within 24 hours were observed. ResultsThe balloon pressure at different time periods was not significantly different between the two groups (P > 0.05). The leakage rate and complication rate were also not significantly different between the two groups (P > 0.05). ConclusionsUsing No. 8 blood collection needles for connecting broken balloon tubes is effective, easy, and convenient, and the balloon can be maintained at a constant pressure. It solved many previous clinical problems such as high cost, high complication rate, high death rate and medical disputes.