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为了了解输血时血中加药引起的变化,笔者对九种常用药液进行试验,发现当在100ml血液中加入氢化可的松50～100mg,或异丙嗪12.5mg、或氯丙嗪12.5～25mg时,开始出现血浆混浊和溶血,因此认为这些药液即使是在常用剂量范围内,也不宜加入血中;100ml血中加地塞米松30mg以内、肾上腺素2mg以内、去甲肾上腺素50mg以内、2％普鲁卡因6ml以内,未见血浆混浊和溶血,因此认为此类药物在常用剂量范围内,对血液影响不大,似可加入,但能由其他通道注入体内时,最好不要加在血中;100ml血中加5％葡萄糖或5％葡萄糖0.9％氯化钠混合液25ml以内,时间短(2小时内)血液无明显改变,但若超过100ml,或在室温停留时间长,则可使红细胞受到损害,若无钠潴留等禁忌,在输血和输液交替过程中,最好间隔输以少量生理盐水。在血瓶内加药由于稀稀作用和缓冲作用有限,易致血液变性,增加染菌机会。所以,除生理盐水、5％白蛋白和血浆及血浆代用品外,原则上不宜在血瓶中随意加药,应尽可能由另外的静脉通道注入。
In order to understand the changes caused by blood dosing during blood transfusion, the author tested nine commonly used medicinal solutions and found that when 100 mL of blood was added to 50-100 mg of hydrocortisone, or promethazine 12.5 mg or chlorpromazine 12.5 - 25mg, began to appear cloudy and hemolysis plasma, so that even those in the liquid dosage range, should not be added to the blood; 100ml blood plus dexamethasone within 30mg, adrenaline within 2mg, norepinephrine within 50mg, 2% procaine less than 6ml, no plasma turbidity and hemolysis, so that such drugs in the usual dose range, little effect on the blood, it may be added, but can be injected into the body by other channels, it is best not to add In blood; 100ml blood plus 5% glucose or 5% glucose 0.9% sodium chloride mixture within 25ml, time is short (within 2 hours) no significant change in blood, but if more than 100ml, or stay at room temperature for a long time, then Red blood cells can be compromised, if there is no sodium retention and other contraindications in the process of blood transfusion and infusion alternation, the best interval to lose a small amount of normal saline. Dosing in the blood bottle due to the role of dilute dilute and limited buffering, prone to cause blood degeneration and increase bacterial chances. Therefore, in addition to saline, 5% albumin and plasma and plasma substitutes, in principle, should not be arbitrarily dumped in blood bottles, as far as possible by the other intravenous access.