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1、1/8 封面2/8 作者：PanHongliang 仅供个人学习输血不良反应的处理制度输血开始后最初 15 分钟严密监测患者，以便发现副作用的早期症状。（一）急性输血反应的处理发生急性输血反应时，首先对血袋标签和患者的身份进行核对，如发现有不文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG
2、8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F
3、4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG
4、8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F
5、4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG
6、8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F
7、4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F43/8 符的地方，立即停止输血并向输血科了解情况。用静脉注射生理盐水维护静脉通路，及时报告上级医师及输血科，对症治疗，
8、在进行积极的治疗抢救的同时，进行必要的核对、检查，保留输血器及血袋封存送检做以下核对检查：核对用血申请单、血袋标签、输血记录单；核对受血者及供血者ABO血型、Rh（D）血型。用保存于冰箱中的受血者与供血者血样、新采集的受血者血样、血袋中血样，重测 ABO 血型、Rh（D）血型、不规则抗体筛查及交叉配血实验（包括盐水相和非盐水相实验）1.第 I 类轻度输血反应采取措施：减慢输血速度；肌注抗组胺药；经过对症治疗，30 分钟内临床表现无好转迹象，或临床表现恶化，则按第 II类输血反应处理。2.第 II类中重度输血反应采取措施：停止输血，更换输血器，以生理盐水保持静脉通路畅通；立即通知病人的主治医师和
9、输血科；将输血器连同剩余的血液、收集的新鲜的尿样和另一只手臂采集的标本（1份抗凝、1份不抗凝）以及有关的申请单，送输血科和检验部门分析；肌肉注射抗组胺类药，口服或注射退热药，对血小板减少的患者避免使用阿司匹林。如表现出过敏反应症状（如支气管痉挛、啸鸣），静脉注射皮质类固醇药；收集 24 小时的尿样送检，以确定是否溶血；如出现临床症状改善，换一袋血液重新开始输注，但速度要慢，并密切观察；如经过处理后 15 分钟内患者临床表现未改善或有恶化的趋势，按第 III类处理。3.第 III类有生命危险的输血反应采集措施：文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编
10、码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I
11、7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编
12、码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I
13、7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编
14、码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I
15、7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编
16、码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F44/8 发生急性输血反应，如：疑为溶血性、细菌污染输血反应、急性肺损伤等，应立即停止输血。停止输血，更换输血器，以生理盐水保持静脉通路畅通；静注生理盐水（开始 2030ml/kg），以维持收缩压；与血压低，5 分钟之内输注，并抬高患者的下肢。保持呼吸道通畅，以面罩给养；缓慢肌肉注射肾上腺素（浓度1:1000），0.01mg/kg；如表现出过敏反应症状（如支气管痉挛、啸鸣），静脉注射皮质类固醇药和支气管扩张药；给予利尿药，如静脉注射速尿2080
17、mg/次，或与之相当的其他药物；立即通知病人的主治医师和输血科；将输血器连同剩余的血液、收集的新鲜的尿样和另一只手臂采集的标本（1份抗凝、1份不抗凝）以及有关的申请单，送输血科和检验部门分析；肉眼观察病人排出的新鲜尿样，确定其是否有血红蛋白尿（血尿或酱油色尿）症状；收集 24 小时尿并记录患者输入和排除液体总量，维持患者液体平衡；检查静脉穿刺部位或伤口出血情况，如果有临床或实验室证据表明发生DIC，输注血小板和冷沉淀或者新鲜冰冻血浆；再次评估患者，如果低血压：进一步输注生理盐水，2030ml/kg，5 分钟；如果需要给予强心剂。如果病人尿量减少或者实验室检查提示有急性肾功能衰竭可能时（钾离子、
18、尿素、肌酐增高）：准确维持液体平衡；加大速尿用量；如需要静脉注射多巴胺；寻求肾病专家帮助，患者可能需要透析。如果怀疑菌血症（寒战、发热、虚脱、无溶血反应表现），给予静脉注射广谱抗菌素，其抗菌谱应包含假单胞菌和革兰氏阴性菌。文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8
19、ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V
20、9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8
21、ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V
22、9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8
23、ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V
24、9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F45/8 如果怀疑输血导致的急性肺损伤发生呼吸困难时：应立即停止输血，给予对症治疗。立即给氧，积极纠正低氧血症，使血氧饱和度90%，轻症 T
25、RALI仅需吸氧，但若并发急性肺损伤及急性呼吸窘迫综合症，则必须进行机械通气，但应注意尽可能吸入低浓度氧，以避免造成氧中毒加重肺损伤，必要时给予呼吸机辅助呼吸、行气管插管或机械通气积极呼吸支持，。必要时在循环稳定的情况下进行呼气末正压通气。加强营养支持治疗，保护各脏器功能。加用肺泡表面活性物质，减轻肺水肿，促使肺泡复张。维持血压稳定。监测血氧分压，进行中心静脉压和肺动脉楔入压监测，不但有利于TRALI的诊断，还有助于液体的管理和维持循环的稳定。同时应用肾上腺皮质激素治疗，静滴氢化可的松200400mg/d 也可静注利尿钠酸或呋塞M，抗组胺药物用于其辅助治疗。（二）溶血性与细菌性输血不良反应处置
26、标准1、ABO 与 Rh（D）血型溶血性输血反应：两人或以上医护人员共同核对病人临床输血申请单、血袋标签、交叉配合实验记录及病史各项内容；输血科两名工作人员共同核对病人及供血者ABO血型、Rh（D）血型。各自单独应用保存于冰箱中的病人与供血者血样、新采集的病人血样、血袋中血样，重新检测 ABO血型、Rh（D）血型、不规则抗体筛查及交叉配血实验包括盐水相和非盐水相实验（间接抗人球蛋白法、酶法、聚凝胺法、玻璃珠法和凝胶法等）；立即抽取病人血液加肝素抗凝剂，分离血浆，观察血浆颜色，测定血浆游离血红蛋白含量；立即抽取病人血液，检测血清间接胆红素含量、血浆结合珠蛋白含量、直接抗人血蛋白实验并检测相关抗体
27、效价，如发现特殊抗体，应作进一步鉴定，严密观察直接抗人球蛋白实验变化情况；记录病人出入量，严密观察尿色变化，尽早检测血常规、尿常规及尿血红蛋文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 Z
28、L2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9
29、C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 Z
30、L2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9
31、C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 Z
32、L2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9
33、C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F46/8 白；必要时，溶血反应发生后57小时测血清间接胆红素含量。2、细菌污染性输血反应：每半小时一次（共2 次），抽取病人血液做细菌学检测；由输血科通知供血机构；在病人或/和直系亲属、医院、供血机构三方共同在场的情况下，
34、抽取血袋中血液做细菌学检测。输血不良反应的点评工作制度1、当发生严重的输血不良反应时，要立即向医务部和输血科报告。2、要对发生以上的事情进行调查，并在输血不良反应登记本上进行详细的记录。3、要保存好患者和供血者输血前的血样（7 天）及与输血有关的所有资料。4、要调查输血申请单、输血记录单、输血反应回报单及输血治疗同意书和受血者乙肝、丙肝、梅毒、艾滋病等原始实验记录。5、要调查供血者的血液的入库、出库登记本，调查供血者的采血日期、条码号、血液制品及数量和乙肝、丙肝、梅毒、艾滋病等检查的原始记录，并将调查情况向医院有关部门汇报。6、如果需要交医院有关部门讨论及医疗鉴定的情况，由科室负责提供材料，由
35、医院选定的专家对患者病情进行充分的论证，提出处理意见，交有关部门按规定执行。7、协助患者向供血单位查找供血者的健康档案，并向上级主管部门汇报。8、当发生严重的输血不良反应的时候，要严格按照有关规定执行。问题处理结束后，科室应开会讨论，对问题的处理进行回顾性分析，找出自身不足之处，即使纠正，完善有关处理程序及制度，按照法律法规处理问题。输血反应应急预案及流程应急预案1、立即停止输血，更换输液管，改换生理盐水。2、报告医生并遵医嘱给药。3、若为一般过敏反应，情况好转者可继续观察并做好记录。4、必要时填写输血反应报告卡，上报输血科。5、怀疑溶血等严重反应时，保留血袋并抽取患者血样一起送输血科。6、患
36、者家属有异议时，立即按有关程序对输血器具进行封存。流程发生输血反应立即停止输血更换输液器输入生理盐水立即停止输血文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码
37、:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7
38、R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码
39、:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7
40、R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码
41、:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7
42、R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F47/8 版权申明本文部分内容，包括文字、图片、以及设计等在网上搜集整理。版权为潘宏亮个人所有This article includes some parts,including text,pictures,and design.Copyright
43、is Pan Hongliangs personal ownership.用户可将本文的内容或服务用于个人学习、研究或欣赏，以及其他非商业性或非盈利性用途，但同时应遵守著作权法及其他相关法律的规定，不得侵犯本网站及相关权利人的合法权利。除此以外，将本文任何内容或服务用于其他用途时，须征得本人及相关权利人的书面立即准备抢救物品、药品病情危重一般反应配合医生积极抢救向患者及家属做好心理疏导必要时氧气吸入与家属、患者有效沟通严密观察病情，做好抢救记录填写输血不良反应记录单及回报单并送输血科将输血器、血袋、余血送往输血科观察并记录必要时对症治疗文档编码:CP3V9C2G3E7 HG8R8I7R6P8
44、ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V
45、9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8
46、ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V
47、9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8
48、ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V
49、9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8
50、ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F4文档编码:CP3V9C2G3E7 HG8R8I7R6P8 ZL2L9N4X7F48/8 许可，并支付报酬。Users may use the contents or services of this article for personal study,research or appreciation,and other non-commercial or non-profit purposes,but at the same time,they shall abide by the prov