问题 问答题 简答题

输血时发生溶血性反应的临床表现及处理?

答案

参考答案:

(1)临床表现:开始阶断,由于细胞凝集成团,阻塞部分小血管可引起头痛,四肢麻木,腰背部剧烈疼痛和胸闷等症状。最后阶断,由于大量血红蛋白从血浆中进入肾小管,遇酸性物质变成结晶体,致使肾小管阻塞,又因为血红蛋白的分解产物使肾小管内质缺血,缺氧而坏死脱落,也可导致肾小管阻塞,患者出现少尿,无尿等急性肾功能衰竭症状,可迅速死亡。

(2)溶血反应还可伴有出血倾向,由于破坏的红细胞释放凝血物质从而引起DIC,消耗血小板和凝血因子,以致出血。处理:①预防,认真做好血型鉴定和交叉配血试验,输血前仔细查对,杜绝差错。严格执行血液保存规则,不可采用变质血液;②发生溶血反应立即停止输血,与医生联系,并保留余血,采集患者血标本重做血型鉴定和交叉配血试验,安慰患者,以缓解恐惧和焦虑。③维持静脉输液,以备抢救时静脉给药。④口服或静脉滴注碳酸氢钠,以碱化尿液,防上或减少血红蛋白结晶阻塞肾小管。⑤双侧腰部封闭,并用热水袋敷双侧肾区,防止肾血管痉挛,保护肾脏。⑥密切观察生命体征和尿量,对少尿、无尿者,按急性肾功能衰竭护理,如出现休克症状,即配合抗休克抢救。

单项选择题
完形填空
完形填空。
     I agree with the saying that some people “see old memories as a chance to deal with the past and
unite past and present.” Many people are so    1   by things that happened in their past that they
are not able to focus on the   2   . For example, in the book Ceremony, the main character, Tayo,
cannot concentrate on the present because he can’t forget his troubled childhood and    3   continues
to relive things that happened during that time.
     However, past memories can help people to    4    in the present. A    5   example of people
learning from the past would be the Marshall Plan. After the   6   of World War II there were many
war-torn countries around the world in need of    7   assistance to help rebuild their countries, and
the United States would have to be the one to    8    that assistance. Many American politicians
thought it was    9   for the US government to spend money abroad on countries that would not be
able to repay it for a long time. However, George Marshall, a former US general, remembered how the
exact same    10   of "why should we spend money on war-torn nations that really owe us reparations
(赔款)?" had been used after World War I towards Germany. The   11    of assistance towards
Germany after World War I had caused a gigantic economic depression in Germany that had made the
Mark (German money) virtually    12   . The German people became so desperate that they started
   13   an extreme German nationalist named Adolf Hitler, who eventually started World War II.
Marshall knew that if the US did not   14   war-torn Germany and, especially, Japan, we could    15  
have a World War III on our hands.
( ) 1. A. shocked
( ) 2. A. memory
( ) 3. A. constantly
( ) 4. A. forget
( ) 5. A. personal
( ) 6. A. conclusion
( ) 7. A. medical
( ) 8. A. need   
( ) 9. A. reasonable
( )10. A. statement
( )11. A. intension
( )12. A. hopeless
( )13. A. refusing
( )14. A. stop   
( )15. A. similarly
B. troubled
B. situation
B. innocently
B. recover
B. scientific
B. decision
B. political
B. provide
B. necessary
B. argument
B. request
B. worthless
B. employing
B. warn
B. simply
C. punished
C. present   
C. ridiculously
C. enjoy   
C. historical
C. invasion
C. economic
C. find   
C. difficult
C. suggestion
C. influence
C. worldwide
C. supporting
C. resist
C. regularly
D. annoyed      
D. future        
D. rarely        
D. compare      
D. commercial    
D. extension    
D. lawful        
D. prevent      
D. foolish      
D. introduction  
D. lack          
D. valuable      
D. charging      
D. help          
D. unlikely