肌肉收缩与舒张练习对预防献血相关血管迷走神经反应的研究

Predonation applied muscle tension to prevent vasovagal reactions to blood donation

目的评估献血者在捐献全血过程中采取肌肉收缩与舒张练习对降低献血相关血管迷走神经反应(DRVR)发生率的有效性。方法选择福州地区2016年5月—2019月6月初次献血的1784名低龄(18—23周岁)献血者,随机分为实验组(n=1083):由血站工作人员在献血过程中指导献血者做肌肉收缩与舒张练习(AMT)并完成采血;对照组(n=701):献血者按常规方式完成献血,其间不做AMT干预。监测2组献血前、后血压与脉率,DRVR发生情况,并通过状态-特质焦虑量表评估2组献血前、后的焦虑水平。结果本组初次低龄献血者DRVR总发生率1.57%(28/1784),其中实验组为0.83%(9/1083)、对照组为2.71%(19/701)(P<0.01);AMT实验组中的获益人群按性别划分女性献血者为50.04%(542/1083)(P<0.01),按全身血容量划分,以≥3300 mL的献血者占比最高[81.81%(886/1083)](P<0.01),按献血量/全身血容量划分,以<10%的献血者比例为最[70.64%(765/1083)](P<0.05)。AMT实验组献血者收缩压波动更小(2.47—8.85 mmHg)(P<0.01);女性献血者中献血后状态焦虑量表得分为6—12分者DRVR发生率更低[1.04%(4/383)](P<0.05)。结论对低龄初次献血者在捐献全血过程中实施AMT能有效降低其DRVR发生率,尤其对低龄初次女性献血者是预防DRVR有效的方法。

Objective To investigate the effectiveness of applied muscle tension(AMT)in reducing the incidence of donation related vasovagal reaction(DRVR).Methods 1784 new blood donors,aged 18—23,during May 2016 to June 2019 in Fuzhou area were enrolled for this study.Those donors were then randomized divided into AMT group(n=1083),practicing AMT during the entire donation under the instruction of blood station staff,and the control group(n=701),without any AMT intervention..The blood pressure and pulse rate of donors in the two groups before and after blood donation were measured,and the incidence of DRVR was monitored.The anxiety level of donors in the two groups before and after blood donation was evaluated by the State Trait Anxiety Inventory.Results The overall incidence of DRVR was 1.57%(28/1784),while AMT group and the control group constituted 9(0.83%,9/1083)and 19(2.71%,19/701)cases respectively(P<0.01).Donors with TBV≥3300 mL(81.81%,886/1083)(P<0.01),the ratio of donation volume to TBV<10%(70.64%,765/1083)(P<0.05)and female(50.04%,542/1083)(P<0.01)in AMT group benefited most from AMT.In AMT group,the systolic blood pressure decreased less after blood donation(2.47—8.85 mmHg)(P<0.01).And female donors with a score of 6—12,graded by State Trait Anxiety Inventory after donation,were less likely to develop DRVR(1.04%,4/383)(P<0.05).Conclusion AMT can effectively reduce the incidence of DRVR in new and young whole blood donors,especially for young female donors.