AN TON TRUYN MU

MC TIU HC TP
1. Trnh bi khi nim v truyn mu v tc dng tc hi ca TM. 2. Nu tm tc khi nim v an ton trong truyn mu. 3. Trnh bi cc ni dung ca an ton TM. 4. Trnh bi cc quy trnh thc hin ATTM.

I. I CNG V TRUYN MU
1. Mu & cc thnh phn mu Mu trong HTH gm 2 phn : - Phn hu hnh: cc TB mu gm: + Hng cu. .

+ Bch cu: bch cu ht, monocyte, lymphocyte. + Tiu cu. - Phn v hnh: huyt tng, cc protein, mui khong, cht ng cm mu, ni tit t, nc...

2. Truyn mu

2. Truyn mu
Truyn mu l a cc thnh phn ni trn vo c th no : - Truyn mu ton phn (MTP).

2. Truyn mu

- Truyn mu tng phn:

+ Khi HC ngho BC. + Hng cu ra. + Khi TC ngho BC. + Khi BC.

2.Truyn mu

+ Huyt tng ti, huyt tng ng lnh. - Truyn cc sn phm ca huyt tng: + Cc YTM: Yu t VIII, Yu t VIII kt ta lnh, Yu t IX. + Albumin. + Gama globulin

3. Tc dng v tc hi ca TM 3.1. Tc dung ca TM - Cu ngi bnh khi mt mu nhiu: chn thng do tai nn, chin tranh; thai ngoi t cung b v; tai bin khi sinh ; cc bnh gy thiu mu; phu thut.

CC BNH ViN SN XuT MU

Ch Ry Bnh vin 175 Vin tim Bv Truyn mu huyt hc - 12000v mu /thng ( khang 450v/ngy). - 818 cup tiu cu/thng (1cup TC = 6v)

3.1. Tc dng ca TM

- Nh TM, pht trin nhiu KTH nh: phu thut ghp t chc, c quan, h tr cho ha tr liu trong tr cc bnh ung th, m rng phu thut trong tr, thn nhn to .

3.1. Tc dng ca truyn mu - Cha c mt s bnh do thiu mt trong cc thnh phn mu nh dng YT VIII,IX tr bnh Hemophili A,B; dng TC tr cho BN thiu TC

3.1. Tc hi ca TM - Gy tai bin nguy him n tnh mng do sai st v Kt TM: nhm tn, xc nh sai nhm, - Ly nhim cc bnh NT nh: HIV, HBV, HCV, CMV; Giang mai, st rt do truyn mu cha sn lc cc bnh ny. - Gy cc P sau TM: phn ng MD, d ng do KT mi hnh thnh do TM.

II. AN TON TRUYN MU

1.1.Khi nim -ATTM l cng vic ht sc quan trng lin quan n mng sng, n bnh tt, nht l cc bnh him ngho nh HIV/AIDS. V vy vic m bo ATTM l mt vic lm tuyt i nghim tc, vi tinh thn trch nhim cao, khng c php s xut.

- Cc bin php m bo ATTM cn tin hnh ng b, khng th b qua. - Ngi lm cng tc TM phi hiu r nhng nguy c gy mt an ton, e da tnh mng sc khe BN,ngi cho mu v nhn vin y t lm cng tc TM. l:

CMV Virus

+ Cc phn ng MD do bt ng nhm mu gia ngi cho v ngi nhn. C th gy hu qu tc khc v lu di. + Ly nhim cc bnh nguy him do mu ngi cho c yu t gy bnh HIV, HBV, HCV,CMV, giang mai, st rt,

+ Cc yu t c hi do BC trong ti mu to nn. Cc yu t ny c th gy st, d ng.

- m bo ATTM cho BN ( ngi nhn mu ) Phi tin hnh cc bin php ton din. Gm cc bc:

Chn ngi cho mu

Lc bch cu

Sng lc cc bnh nhim trng Sn xut cc thnh phm mu

Ni dung ATTM
La chn mu ph hp, pht mu an ton.

Truyn mu t thn

Ch nh ng truyn mu

2. Ni dung ATTM Vi khi nim rng: An ton TM l khng xy ra bt k iu nguy him no cho ngi hin mu, ngi nhn mu v ngi phc v TM.

2.1. An ton ngi cho mu Mun vn ng hin mu c KQ, trc ht phi m bo AT tuyt i cho ngi hin mu, cn lm tt nhng vic sau: - Trong khm tuyn chn, phi ht sc tn trng cc iu kin ngi c kh nng cho mu. Phi tn trng tinh thn tnh nguyn ca ngi cho mu ng thi phi khm mt cch c h thng v SK ngi cho mu, nht l ngi cho mu ln u .

2.1. An ton ngi cho mu

- Bo m k thut ly mu an ton. Chm sc v duy tr ngun ngi cho mu, gip h c thc t bo v v nng cao sc khe c th cho mu c 2-3 ln trong nm. - T vn n nng cao hiu bit ca ngi HM nhm nng cao trch nhim ca h i vi ATTM.

2.1. An ton cho ngi nhn mu y l yu cu, mc ch chnh ca ATTM. - An ton v min dch: + m bo i sng bnh thng TB mu ca ngi cho mu trong c th ngi nhn mu ( bnh nhn ). + Bo v i sng bnh thng TB mu ca bnh nhn. Ngn chn nguy c MD trong c th do yu t ngi cho em li.

- An ton khng ly lan: + Mu ngi cho khng c lm ngi bnh mc cc bnh truyn qua ng mu nh : HIV, HBV, HCV,CMV, Giang mai, st rt, giun ch, Loi b mu hoc ch phm mu b NT trong qu trnh ly mu, bo qun mu v truyn mu.

2.3. An ton cho nhn vin y t

- C bin php phng nga tt. - C nhn t gic thc hin. - Cung cp y cc bin php phng nga. - Thc hin nghim tc nguyn tc chng nhim khun.

III. CCH THC HIN ATTM 1. m bo cht lng mu v cc ch phm mu - An ton v MD: Mu v cc ch phm mu khi a vo c th ngi nhn phi c gim n mc ti a cc PMD. t c iu ny th nhn vin y t phi thc hin ng cc nguyn tc sau :

+ Thc hin nh nhm mu ABO chnh xc bng hai phng php : PP dng hthanh mu (Beth Vincent) dng KT trong hthanh bit l anti A, anti B, anti AB xc nh KN tng ng trn b mc HC.

 PP dng HC mu (Simonin): dng HC mu bit trc KN l: HC A mang KN A, HC B mang KN B xc nh KT tng ng trong hthanh.

Hai PP ny phi c tin hnh ng thi do 2 KTV lm c lp xc nh chnh xc nhm mu.

+ Huyt thanh mu ABO phi t cht lng cao (c hiu) khng phn ng vi cc KN khc.
+ Chn n v mu ph hp h ABO:

Mu c chn truyn Mu bnh nhn Chn tt nht Chn mu khi khng c mu cng nhm vi BN Chn th 2 O A Khi HC O Khi HC O Chn th 3 O Chn th 4

O A

A1 (C anti H)
A2 (c anti A1)

A1
A2 Khi HC O

B
AB A1B(c anti H)

B
AB A1B

Khi HC O
Khi HC A or B Khi HC A1 or B

O
Khi HC O A or B A1 or B

A2B (c antiA1) A2B

Khi HC A2 or B

Khi HC O A2 or B

S truyn HC, mu TP
A A O O
B AB AB

S truyn huyt tng

A A AB AB
B

+ Lm CNPH 3 giai on. + Chn n v mu ph hp, HLA, HPA. Hin nay, ta cha th lm ph hp cho tt c mi ngi HM v NM v h HLA v HPA. Do , cn lm hn ch s lng BC, TC ca ti mu trc khi truyn cho ngi TM nhiu ln, ph n sinh nhiu ln . Dng khi HC truyn s gim bt P st rt run cho ngi bnh.

- Khng ly lan cc bnh nh HIV, HBV, HCV,CMV, giang mai, st rt, giun ch,v cc bnh NT khc: + Tuyn truyn nhng ngi khe mnh hin mu. + Khm ton din ngi hin mu.

An ton khng ly lan + Ly mu an ton. + Sng lc cc bnh NT bng PP huyt thanh hc i vi ti mu. + iu ch bo qun ng cch.

2. m bo khng xy ra nguy c nhm ln - Khng nhm ln v th tc hnh chnh: + i chiu phiu xin mu, kt qu chn mu, ti mu, ngi bnh. + Phi nh li nhm mu bnh nhn v ti mu ti ging. Lm P cho ti ging bng mt git mu BN v mt git ca ti mu.

2. m bo khng xy ra nguy c nhm ln - Khng nhm ln v ch nh: + Phi xc nh ng i tng c truyn, loi ch phm,s lng v tc truyn. + Phi khm li BN trc khi truyn bit tnh trng BN trc truyn mu v d on hu qu trong khi truyn./.

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