紧急大剂量成分输血患者的观察及护理

Observation and nursing for patients treated by emergent massive blood component transfusion

目的探讨紧急大剂量输血的观察及护理要点，保证患者紧急大剂量成分输血的安全性、有效性、及时性。方法对33例急性大失血患者均采用少白细胞红细胞、新鲜冰冻血浆、冷沉淀及血小板等成分输血，根据病情调整不同成分输入的顺序、剂量及速度，输血过程密切观察患者体温、尿液、血压及伤口出血情况的变化。结果本组循环血量得到有效补充、血压及组织供氧恢复者26例；循环血量未得到有效补充、血压及组织供氧未有效恢复者7例。结论对紧急大失血患者采用成分输血可取得较好疗效，护士应了解各种血液成分制品的特点，在输血过程中密切观察患者的体温、尿液、血压及伤口出血情况的变化，以保证紧急大剂量成分输血患者的安全。

Objective In order to know the observative and nursing points for patients treated by emergent massive blood component transfusion, and make clear the safety and efficacy of this method. Methods Observed 33 patients of major blood loss were treated by transfusion of leukocyte-reduced red blood cells, fresh frozen plasma, cryoprecipitate and platelets. Regulated the sequence of different blood components, quantity and the transfusion velocity according to the present situation of patients. And observed closely the changes of body temperature, urine, blood pressure and hemorrhage of wound. Results There were 26 patients to have got recovery of blood circulation, blood pressure and tissue oxygen supply, and only 7 patients not. Conclusions Component transfusion for the patients of acute massive blood loss has good therapeutic effect. It is important that nurses should know the features of different blood components and observe closely the present situation of body temperature, urine, blood pressure and hemorrhage of wound.