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【Objective】 To investigate the risk factors of vasovagal reactions(VVR) related to plasma donation, so as to put forward clinical suggestions for early identification and accurate intervention of high-risk groups to ensure the safety of plasma donation. 【Methods】 The demographic characteristics(i.e. gender, age, weight) and records of plasma donors(donation history, pulse before plasma donation, duration of collection, etc.) were collected from July to December 2019 in a region of Sichuan. Based on logistic regression analysis, the correlation between these factors and the risk of VVR was explored. 【Results】 The information of 69 172 donors was collected, and the incidence of VVR was 7.04‰. The risk of VVR was reduced by 99% in the group with plasma collection duration less than 30 minutes compared with the group with plasma collection duration more than 50 minutes(OR, 0.01; 95% CI, 0.00~0.01; P<0.001). The risk of male group was 94 % lower than that of female group(OR, 0.06; 95% CI, 0.04~0.10; P<0.001). Compared with the 45~50 kg group, the risk of weight greater than 80 kg group decreased by 80%(OR, 0.20; 95% CI, 0.09~0.42; P<0.001). The risk of repeated donation group was 34 % lower than that of the first time donation group(OR, 0.66; 95% CI, 0.47~0.91; P<0.001). The risk of VVR in the group with pulse greater than 90 bpm before plasma donation was 2.43 times that in the 60~69 bmp group(OR, 2.43; 95% CI, 1.75~3.36; P<0.001). 【Conclusion】 Duration of plasma collection, gender, weight, frequency of plasma donation, pulse before plasma donation and donor status are independent risk factors for plasma donation-related VVR. Among them, plasma collection duration, gender and weight were the main independent risk factors for plasma donation-related VVR. For donors with plasma collection duration more than 50 minutes, female and low weight, higher risk of VVR was presented and more preventive intervention should be given.
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Donation related vasovagal reaction(DRVR) is the most common adverse reaction during blood donation. It is very important for blood banks to identify, treat and prevent DRVR accurately. At present, it is generally believed that psychological factors are the first major inducement of DRVR. Applied muscle tension (AMT) and salt supplementation have been proved to be effective interventions for vasovagal response; the identification methods of high-risk groups such as State Trait Anxiety Inventory, Medical Fear Inventory and Blood Donor Response Scale have been relatively mature, but the utilization rate is relatively low in China. In this paper, the main clinical manifestations, pathogenesis, research methods, related factors, management and prevention measures of DRVR, as well as the identification of high-risk groups before blood donation are reviewed.
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Objective To retrospectively compare the image quality and radiation dose for coronary CT angiography obtained with a prospectively gated transverse (PGT) CT technique and a retrospectively gated helical (RGH) CT technique. Methods Coronary CT angiography obtained with 256-slice CT were retrospectively evaluated in 177 patients. The main branches of coronary arteries were divided into 9 segments. The image quality was evaluated with a four-point grading scale. The assessability of coronary artery segment, image quality score and radiation dose for prospective and retrospective CT angiography were compared with student t test. Results The PGT technique was used in 86 patients. The routine RGT technique was used in 91 patients. The percentage of assessable coronary artery segments was 98. 8% (765 of 774)with PGT technique versus 99. 6% (816 of 819) with RGH technique (t = 2. 51, P = 0. 01 ). In patients with heart rates under 75 beats per minute, the image quality of coronary artery branches was similar between PGT and RGH techniques (99. 8% versus 99. 7%, t = 1.90, P > 0. 05 ) . In patients with heart rates above 75 beats per minute, the image quality with RGH technique was better than that with PGT technique (99.0% versus 93. 6%, t = 3.57, P < 0. 05 ). Effective dose with prospective CT angiography was 60. 0% lower than that with retrospective CT angiography [ (4. 4 ± 0. 5 ) vs ( 10. 3 ± 1.5 ) mSv, t = 33.4,P <0. 05 ]. Conclusions Prospective CT angiography can reduce effective radiation dose obviously. The PGT technique offers the similar image quality with RGH technique in patients with heart rates under 75 beats per minute and RGH technique has better image quality in patients with heart rates above 75 beats per minute.
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Objective To apply early comprehensive rescue including embolism and microsurgery for trea- ting acute ruptured intracranial aneurysm in order to lower mortality and disability.Methods 120 patients with rup- tured intracranial aneurysm were treated by early comprehensive rescue.An cases were given support treatment,e- mergency rescue and DSA after hospitalization.Embolism and microsurgery were done within 72 hours and releasing bleeding CSF were done after surgery to prevent complications.Results Good recovery was over 80%(excellent in 95 ases,light disability in 18 cases,heavy disability in 4cases,and death in 3 cases).2 cases relapsed during hospi- talization.5 cases were coma induced by serious cerebral vesospasm.Conclusion Early comprehensive treatment including embolism and microsurgery complication prevention may reduce rebleeding,serious vasospasm and hydro- cephalus,1ower mortality and improve prognosis.