年轻献血者血管迷走神经反应观察

Observation on the vasovagal reaction of young blood donors

目的通过对在校大学生献血者血管迷走神经反应（vasovagal reaction,VVR）的观察,了解年轻献血者VVR的相关危险因素,以采取干预手段减少VVR的发生。方法观察并记录了7 359例18—22岁的在校大学生献血者献全血时发生VVR的情况,收集了发生VVR者的性别、年龄、BMI、献血史、VVR的程度、VVR的发生时间等因素,并进行分析。结果在7 359例18—22岁的学生中,有482例发生VVR,发生率为6. 55%,VVR的发生与性别、年龄、BMI无关,但其程度与其发生时间呈显著相关（χ~2=19. 57,P〈0. 001）,且VVR发生时间主要集中在采中及采后5 min内（占所有不良反应发生率分别为25. 3%,49. 8%）,较严重VVR的发生主要集中在采后0—10 min。同时,观察提示初次献血者较重复献血者的VVR程度显著增强（χ~2=5. 11,P〈0. 05）。所有VVR在采取平卧位、饮用糖盐水后均可迅速完全缓解。结论年轻献血者尤其是初次献血者如果能在采血后保持5—20 min平卧位观察,献血前适量饮用糖盐水,将大幅度减少VVR的发生。

Objective Vasovagal reaction（ VVR）,a common adverse event associated with blood donation,is more common in young blood donors. Here,we observed the VVR of whole blood donors in college students to identify the related risk factors of VVR.AimWeplan to take intervention measures to reduce the occurrence of VVR and thusimprove the safety of blood donation.Methods We observed and recorded 7359 college students aged 18—22 years and collected information including gender,age,BMI,blood donation history,the degree of VVR,the occurrence time point of VVR after donation etc,and analyzed the risk factorsof VVR.Results A total of 482 students suffered VVR（ 6. 55%）. The incidence of VVR was not related to gender,age,and BMI but was significantly correlated with the time delay after donation（ χ~2= 19. 57,P 0. 000 1）. VVR mainlyoccurred during the donation process or within 5 min after blood donation（ 25. 3% and 49. 8% respectively）. However,severe VVR mainly took placebetween 0—10 minutes after blood donation. The incidence and degree of VVR are much higher in first—time donors than experienced donors. All VVR could be completely relieved after taking supine position,drinking sugar brine within 5—20 minutes.Conclusion The VVR of young blood donors can be significantly reducedwithan appropriate amount of sugar brine before donation and supine positioningwithin 5—20 minutes after donation.