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靜脈輸血的寧靜節制技能

來歷:本站采編 閱讀次數: 日期:2018-04-20 15:01:30


Blood Transfusion
靜脈輸血的寧靜節制技能


靜脈輸血.jpg


       靜脈輸血(blood transfusion) 是將全血或成份血如血漿、紅細胞、白細胞或血小板等經由過程靜脈輸出體內的方式。

01

靜脈輸血的目標

補充血容量、改正血虛、補充血漿卵白、補充各類凝血因子和血小板 、補充抗體補體等血液成份、解除無害物資。




02

靜脈輸血的準繩

ASHUXUEQIANBIXUCHAYANXUEXINGJIZUOCHUANCHAPEIXUESHIYAN

BBUGUANSHISHUQUANXUERENGSHISHUCHENGFENXUE,JUNYINGXUANYONGTONGXINGXUEYESHUZHU

CHUANZHERUOSHIXUYAOZAICISHUXUE,ZEBIXUCONGTOUZUOCHUANCHAPEIXUESHIYAN


03

靜脈輸血方式

三查:查血的有用期、血的品質、輸血裝配是不是無缺

八對:對姓名、床號、住院號、血袋(瓶)號(儲血號)、血型、穿插配血實驗的成果、血液的品種、血量

【操縱步驟】

(1)JIANJIESHUXUEFA:ZAICICHACHAOHEDUI—CHENGLIJINGMOTONGDAO -YAOYUNXUEYE -PILIANXUEDAIEZHISHUXUE -JIEZHIHEDIAOLIDISU -CAOZONGHOUCHUZHI -XUXUEDECHUZHI -SHUXUEZHONGLEHOUDECHUZHI

(2)JIANJIESHUXUEFA:CHOUBANWOWEI—HEDUI—CHOUQUKANGNINGJI—CHOU、SHUXUEYE(SANRENGONGTONG:YIRENCHOUXUE,YIRENTONGBAO,LINGWAIYIRENSHUZHU,RUSICHIXUEZHI)—SHUXUEZHONGLEHOUDECHUZHI


04

罕見輸血反映與照顧護士

           

1


發燒反映

AFANGBEI:YANKUBANLIXUEKUYIYANGYEHESHUXUEQIJU

BCHUZHI

aFANYINGQINGZHE:JIANMANSHUXUESULV

bFANYINGZHONGZHE:DANGJIEZHISHUXUE,JINMIQINMICHAKANXINGMINGTIZHENG,SIYUDUIZHENGCHUZHI,BINGSHISHIGAOSUDAFU

cXUYAOSHIZUNYIZHUSIYUJIEREZHENTONGYAOHEKANGGUOMINYAO

dJIANGSHUXUEQI、CANSHENGXUELIANTONGZHUXUEDAIYIBINGSONGJIAN




2


過敏反映

    A防備

   aZHUNQUEBANLIXUEYEHEXUECHENGPIN

   bXUANYONGWUGUOMINSHIDEGONGXUEZHE

   cGONGXUEZHEZAICAIXUEQIAN4XIAOSHINEIBUYICHIGAOLUANBAIHEGAOZHIFANGDESHIPIN

   dDUIYOUGUOMINSHIDEHUANZHE,SHUXUEQIANANZHAOYIZHUSIYUKANGGUOMINYAOWU

   B處置

   aJIANCEXINGMINGTIZHENGBIANGENG

   bQINGZHEJIANMANSHUXUESULV;ZHONGZHEEZHISHUXUE

   cHUXIJIANKUZHEXIYANG,YANJUNZHEXINGQIGUANQIEKAI

   dLUNHUISHUAIJIEZHESIYUKANGXIUKEYIZHI


3


溶血反映

     A血管內溶血的防備

       aZUOHAOXUEXINGPANDINGHECHUANCHAPEIXUESHIYAN

       bSHUXUEQIANXIXINHEDUI

       cYANKULVXINGXUEYEBAOGUANHUADING

       dBULIYONGTUIBIANXUEYE

    B血管內溶血的處置

      a 當即遏制輸血,并告訴大夫

      b 賜與氧氣吸入,成立靜脈通道,遵醫囑賜與升壓藥或其余藥物醫治

      c 將剩下的余血、患者血標本和尿標本送化驗室遏制查驗

      d 掩護腎臟

      e 堿化尿液

      f 周密察看性命體征和尿量

      g 若呈現休克癥,應遏制抗休克醫治

      h 心思照顧護士



     
4

      與大批輸血有關的反映

      A 大批輸血是指24小時內告急輸血量相稱于或大于患者總血容量

      B 罕見的反映及照顧護士

      a 輪回負荷過

      b 出血偏向 :

        b1  緊密親密察看患者的意識、血壓、脈搏等變更

        b2  注重皮膚、粘膜或手術傷口有沒有出血

        b3  嚴酷把握輸血量

        b4  按照凝血因子缺少環境補充有關成份

      c  枸櫞酸鈉中毒 : 每輸庫血1000ml,靜脈打針10%葡萄酸鈣10ml

     
5

      其余輸血反映

      FENWEISHUANSAI、XIJUNJINGHUAFANYING、TIWENTAIDI、JINGYOUGUOCHENGSHUXUEZHANRANGELEIJIBING(BINGDUXINGGANYAN、NVEJI、AIZIBING)


05

血液成品的品種

(1)全血:新穎血、庫存血

(2)成份血

A 血漿:新穎血漿、保管血漿、冰凍血漿、枯燥血漿

B 白細胞稀釋懸液

C 各類凝血制劑

D 紅細胞:稀釋紅細胞、洗濯紅細胞、紅細胞懸液

E 血小板稀釋懸液

(3)其余血液成品:白卵白制劑、纖維卵白原、抗血友病球卵白稀釋劑

06

靜脈輸血的順應證與忌諱證

(1)JINGMOSHUXUEDESHUNYINGZHENG:GELEIYUANYOUYINFADEDACHUXUE、XUEXUHUODILUANBAIXUEZHENG、YANJUNCHUANRAN、NINGXUEGONGXIAOFANGAI

(2)JINGMOSHUXUEDEJIHUIZHENG:JIXINGFEISHUIZHONG、CHONGXUEXINGXINLIRUOJIE、FEISHUANSAI、EXINGGAOXUEYA、ZHENXINGHONGXIBAOZENGJIAZHENG、SHENGONGXIAOJIDUANSHUAIJIE、DUISHUXUEYOUSHICHANGFANYINGZHE













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