临床输液热原反应的原因探讨及其预防

<正> 临床输液反应中,危害最大发生率最高的是热原反应。输液当中热原逐渐进入体内,当超过患者耐受量时,便可发生热原反应。它虽与患者体质(内在因素)有关,但主要还是由于大量热原输入的结果。要克服热原反应,显然要从热原污染来源上着手,而不应当强调患者方面的因素。

INVESTIGATION ON THE CAUSE AND PREVENTION OF PYROGEN REACTION IN CLINICAL TRANSFUSION

In order to reduce the pyrogen reaction during clinical transfusion in hospitals of Datong city, the pharmaceutical products, transfusion sets and syringes were examined with LAL test. Simulated transfusion experiment was also carried out on ward to observe pyrogen contamination caused by manipulation and envi ronmental factors. The result of examination and clinical use indicated that the main cause of pyrogen reaction during clinical transfusion in Datong city was incomplete removal of pyrogen during cleaning and sterilization of transfusion sets and syringes. The transfusion sets in all of the hospitals with pyrogen reaction were found to be contaminated by pyrogen, while pyrogen reaction never occurred in hospitals where the transfusion sets and syringes showed negative result to pyrogen test.In order to remove the pyrogen on transfusion sets and syringes, a method of four-step treatment consisting of removing dirt, pyrogen, detergent and tap water was proposed. It was proved in experiment that immersing the rubber tube in 4% HCl(w/v) was more effective than boiling it in alkaline solution (0.5% NaOH~2 2% Na_2CO_3 or 2% NaHCO_3 ) for removing the pyrogen.After the treatment of transfusion sets and syringes for removing pyrogen was improved, the rate of pyrogen reaction in one of the hospitals observed reduced from 20% (844/4221) to 0.05% (5/10828). Since the above mentioned method for removing pyrogen on transfusion set and syringe was popularized in all of the hospitals of Datong city, the rate of pyrogen reaction decreased to only 0.02% during the first eight months in 1985.