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“天使”怀抱4度血袋:你也这么看?

2016-03-04 MedSci MedSci原创

小M的微博和朋友圈几乎被抱“冰血袋”的医生们刷了屏,遇到这种正能量的事件怎么能不传递? 事件回放: 2月24日,一位23岁的初产妇,顺产宝宝后,一切看似很顺利很平静。但就在产后观察期间,一些微妙的变化出现了,新妈妈产后出血量不同于寻常,医生观察到了,给予注射促宫缩药物,按摩子宫等止血措施,但在短暂止血后的一个小时内产妇再次大出血,染红的床单,1500ml的监测失血总量,产妇早期失血性休克的表现

小M的微博和朋友圈几乎被抱“冰血袋”的医生们刷了屏,遇到这种正能量的事件怎么能不传递?

事件回放:

2月24日,一位23岁的初产妇,顺产宝宝后,一切看似很顺利很平静。但就在产后观察期间,一些微妙的变化出现了,新妈妈产后出血量不同于寻常,医生观察到了,给予注射促宫缩药物,按摩子宫等止血措施,但在短暂止血后的一个小时内产妇再次大出血,染红的床单,1500ml的监测失血总量,产妇早期失血性休克的表现无不让科室的医护人员心急如焚。很快,三袋救命血被送来,事发突然,未提前准备下,复温器尚来不急将4度保存的血袋瞬时恢复至活性状态。情急之下,宁大附属医院姚路医生急忙怀抱血袋,在30分钟内控制住了产妇病情,冰冷了的姚路一人的胸膛在那一刹那却温暖了很多人的心。

无独有偶,2月27日凌晨,郑大一附院的一位多发骨折患者,在进行骨折复位内固定术时,因手术困难,持续4个小时多的手术在患者失血过多的状态下仍不能下台,大剂量输血是必须的了,但血浆复温的速度却赶不上输血的速度,怎么办?急诊科医生张润把从冰箱拿出来的4度左右血袋搂在怀里,同样的举措,同一份感动,在延续着。

这些照片在感动无数网友的同时,也有不少人疑问,病人输血,都需要这样吗?你怎么看呢?

通常情况下手术室用的水浴箱复温,但在特殊情况下,手暖血袋也是很多见的,这回胸膛复温血袋似乎更让我们看见了那份正能量。

医院里为了延长血液的保存时间,全血、红细胞冷藏温度应当控制在2~6度,防止凝固、保证细胞新陈代谢所需的营养、延长在体外的寿命、保证输给病人后能发挥相应的功能。在这个时候,血液处于一种“休眠”状态,生理活性不强。血小板保存于特制的袋内,温度应当控制在20~24度并不断振荡,可保存5天;新鲜冰冻血浆在-20度以下可保存1年。为了能满足临床急救和治疗的需求,血液的采集、血液的保存和血液的临床使用都是很有计划和讲究的,差之毫厘谬以千里!

目前临床上血袋的复温方式一般有两种方法,一是将血袋放在专门的水浴箱里,在37℃水浴箱中融化并不断地摇动血袋以缩短融化时间(融化得越快,形成的絮状沉淀物就越少,避免大量纤维蛋白析出来阻塞针头;二是可以用热水袋覆盖在患者输血的胳膊上。

在手术紧急用血时,特别是大量用血时,医生是来不及放在水浴箱里的,更不可能用热水袋放在患者胳膊上。血液在人体内,一般是37度,这个时候生理活性最强。从专业上角度看,血液加热时是不能超过人体温度的,否则红细胞会被杀死,面临突发大输血,用体温加温的方式是合情也合理的。故而以上两位“天使”的做法可谓既科学又感人!

网友或从人性角度理解

@慕芷缘之雪:看到这一幕,眼眶早已湿润,我不明白那些口口声声说纯属作秀的人什么心态,要不你试试把4度的东西放在自己只穿一件体恤的身上感觉下,有这样作秀的吗?

@Lif黎LYHHC:这已经超越医生的界限了,作为一名医生有这么高的责任感,少见,让人佩服!

网友或从专业角度理解

@有氧妹子V:这是复温, 复温和加温的区别, 是救人,为何有如此多的质疑声!

@曹三子桓:为什么血袋不能用水浴加热?水浴箱控制温度20以下不行?手术室室温也有26度了,不存在突然升温导致红悬的细胞破裂。我是觉得揣怀里捂热没什么好质疑的,权宜之计,但解释说水浴就不行这也不对。手术室多是无菌环境,而水浴箱最容易滋生细菌。事实就是手术室都不会配备水浴箱。而并不是连个恒温水箱都买不起!

你怎么理解呢,赶紧给小M留言吧!

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  1. [GetPortalCommentsPageByObjectIdResponse(id=83216, encodeId=172c8321654, content=媒体应多传播这类正能量, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Thu Apr 28 20:58:00 CST 2016, time=2016-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67600, encodeId=4d726e600b6, content=我们连细胞层流室都不放水浴箱……U can U up, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=c4491649063, createdName=沙丁鱼牙, createdTime=Sun Mar 06 17:01:00 CST 2016, time=2016-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67318, encodeId=96c86e3187b, content=在手术室很常见, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Sat Mar 05 10:43:00 CST 2016, time=2016-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67211, encodeId=5abf6e2114f, content=司空见惯,不足挂齿, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Fri Mar 04 19:03:00 CST 2016, time=2016-03-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67207, encodeId=b4376e2077b, content=支持一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160219/IMG56C6C68249B6F6895.jpg, createdBy=4a1b1689144, createdName=tiffany8083, createdTime=Fri Mar 04 18:43:00 CST 2016, time=2016-03-04, status=1, ipAttribution=)]
    2016-04-28 明崖

    媒体应多传播这类正能量

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=83216, encodeId=172c8321654, content=媒体应多传播这类正能量, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Thu Apr 28 20:58:00 CST 2016, time=2016-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67600, encodeId=4d726e600b6, content=我们连细胞层流室都不放水浴箱……U can U up, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=c4491649063, createdName=沙丁鱼牙, createdTime=Sun Mar 06 17:01:00 CST 2016, time=2016-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67318, encodeId=96c86e3187b, content=在手术室很常见, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Sat Mar 05 10:43:00 CST 2016, time=2016-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67211, encodeId=5abf6e2114f, content=司空见惯,不足挂齿, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Fri Mar 04 19:03:00 CST 2016, time=2016-03-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67207, encodeId=b4376e2077b, content=支持一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160219/IMG56C6C68249B6F6895.jpg, createdBy=4a1b1689144, createdName=tiffany8083, createdTime=Fri Mar 04 18:43:00 CST 2016, time=2016-03-04, status=1, ipAttribution=)]
    2016-03-06 沙丁鱼牙

    我们连细胞层流室都不放水浴箱……U can U up

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=83216, encodeId=172c8321654, content=媒体应多传播这类正能量, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Thu Apr 28 20:58:00 CST 2016, time=2016-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67600, encodeId=4d726e600b6, content=我们连细胞层流室都不放水浴箱……U can U up, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=c4491649063, createdName=沙丁鱼牙, createdTime=Sun Mar 06 17:01:00 CST 2016, time=2016-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67318, encodeId=96c86e3187b, content=在手术室很常见, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Sat Mar 05 10:43:00 CST 2016, time=2016-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67211, encodeId=5abf6e2114f, content=司空见惯,不足挂齿, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Fri Mar 04 19:03:00 CST 2016, time=2016-03-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67207, encodeId=b4376e2077b, content=支持一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160219/IMG56C6C68249B6F6895.jpg, createdBy=4a1b1689144, createdName=tiffany8083, createdTime=Fri Mar 04 18:43:00 CST 2016, time=2016-03-04, status=1, ipAttribution=)]
    2016-03-05 老段

    在手术室很常见

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=83216, encodeId=172c8321654, content=媒体应多传播这类正能量, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Thu Apr 28 20:58:00 CST 2016, time=2016-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67600, encodeId=4d726e600b6, content=我们连细胞层流室都不放水浴箱……U can U up, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=c4491649063, createdName=沙丁鱼牙, createdTime=Sun Mar 06 17:01:00 CST 2016, time=2016-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67318, encodeId=96c86e3187b, content=在手术室很常见, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Sat Mar 05 10:43:00 CST 2016, time=2016-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67211, encodeId=5abf6e2114f, content=司空见惯,不足挂齿, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Fri Mar 04 19:03:00 CST 2016, time=2016-03-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67207, encodeId=b4376e2077b, content=支持一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160219/IMG56C6C68249B6F6895.jpg, createdBy=4a1b1689144, createdName=tiffany8083, createdTime=Fri Mar 04 18:43:00 CST 2016, time=2016-03-04, status=1, ipAttribution=)]
    2016-03-04 dhzzm

    司空见惯,不足挂齿

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=83216, encodeId=172c8321654, content=媒体应多传播这类正能量, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Thu Apr 28 20:58:00 CST 2016, time=2016-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67600, encodeId=4d726e600b6, content=我们连细胞层流室都不放水浴箱……U can U up, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=c4491649063, createdName=沙丁鱼牙, createdTime=Sun Mar 06 17:01:00 CST 2016, time=2016-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67318, encodeId=96c86e3187b, content=在手术室很常见, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2d331664955, createdName=老段, createdTime=Sat Mar 05 10:43:00 CST 2016, time=2016-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67211, encodeId=5abf6e2114f, content=司空见惯,不足挂齿, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Fri Mar 04 19:03:00 CST 2016, time=2016-03-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=67207, encodeId=b4376e2077b, content=支持一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160219/IMG56C6C68249B6F6895.jpg, createdBy=4a1b1689144, createdName=tiffany8083, createdTime=Fri Mar 04 18:43:00 CST 2016, time=2016-03-04, status=1, ipAttribution=)]
    2016-03-04 tiffany8083

    支持一下

    0

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