恩施地区某县中心医院用血控制情况分析

目的统计分析该院2013-2017年住院人数、手术台次及用血量,评价用血控制情况,以指导临床合理用血。方法对2013-2017年该院住院、手术患者数量及红细胞、血浆、冷沉淀、血小板用量进行统计,分析各血液成分用量情况。结果住院人数和手术台次呈逐年增加趋势,但红细胞、血浆总用量和人均使用量却逐渐减少,冷沉淀用量2013-2015年逐渐减少,2015-2017年呈逐渐增加趋势。结论该院对稀缺的红细胞和血浆用量控制较好,各血液成分分配合理,临床用血合理、有效。

Voltammetric Trace Determination of Prednisolone in Human Serum and Urine-Studies the Interaction with Albumin

The Voltammetric properties of Pure Prednisolone in a direct method in the aqueous solution were studied. The substance has revealed a clear and major two reduction peaks at potential -1.22 Volt and -1.45 Volt against the reference electrode （Ag/AgCI/SatKC1）. The calibration curve of the prednisolone in the Phosphate Buffer （pH = 7） has been studies. The relationship has been linear within the scope of concentration 0.398 × 10 6-3.846 ×10-6 mol. The correlation coefficients are 0.9981, 0.9958 for the first and second peaks. Another two calibration curves were also constructed in the presence of human serum and urine. Standard addition method was successful used to determine the drug in serum, urine as well as in the analysis of drug in the tablet. The molecular binding ofprednisolone with Albumin was also studied at different temperature. The Vant hoff equation is used to calculate the thermodynamic parameters, the results indicate that the （ion-ion） of binding suggested.

中等比例输注冰冻血浆与红细胞对创伤后失血性休克患者凝血四项指标变化的影响

目的研究中等比例输注冰冻血浆(FP)与红细胞(RBC)对创伤后失血性休克患者的效果。方法选取2018年9月—2019年9月西华县人民医院收治的创伤后失血性休克患者123例,其中41例采用FP:RBC≤1∶2输血为低比例组,41例采用FP:RBC=1∶2~1∶1输血为中等比例组,41例采用FP:RBC≥1∶1输血为高比例组。比较3组血液制品使用量[FP、RBC、血小板(PLT)、冷沉淀]、输血前、输血后凝血四项指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)]、氧代谢指标[氧摄取率(O2ER)、动脉血氧分压(PaO2)、氧供(DO2)]及预后情况(治愈、未治愈、死亡)。结果高比例组FP用量大于中等比例组、低比例组,且中等比例组大于低比例组(P<0.05);3组RBC、PLT、冷沉淀使用量比较,差异无统计学意义(P>0.05);输血后中等比例组PT、APTT、TT低于低比例组、高比例组,FIB高于低比例组、高比例组,且高比例组PT、APTT、TT低于低比例组、FIB高于低比例组(P<0.05);输血后中等比例组O2ER、PaO2、DO2高于高比例组、低比例组,且高比例组高于低比例组(P<0.05);3组治愈、未治愈、死亡等预后情况比较,差异无统计学意义(P>0.05)。结论对创伤后失血性休克中等比例输注FP与RBC可调整血浆输注量,且能减少对凝血四项指标的影响,提升氧代谢指标,预后效果较好。