血細胞分離機常見故障及維護保養(yǎng)

1、 常見問題處理方法及技巧 張建強 Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 顯示屏顯示屏控制面板控制面板離心機離心機溶液袋支架

2、溶液袋支架抗凝劑空氣監(jiān)測器抗凝劑空氣監(jiān)測器(ACAD)抗凝劑抗凝劑(AC )泵泵輸送泵輸送泵血液泵血液泵閥門閥門電源開關電源開關獻血員管路空氣監(jiān)測器獻血員管路空氣監(jiān)測器(DLAD1)獻血員管路空氣監(jiān)測器獻血員管路空氣監(jiān)測器(DLAD2)獻血員壓力監(jiān)測獻血員壓力監(jiān)測器器(DPM)血液容器支架環(huán)血液容器支架環(huán)內循環(huán)容器支架環(huán)內循環(huán)容器支架環(huán)固定掛銷固定掛銷閥門閥門袖袋袖袋(背后背后)系統(tǒng)壓力監(jiān)測器系統(tǒng)壓力監(jiān)測器(SPM)程序卡插入門程序卡插入門獻血員流量指示燈獻血員流量指示燈 (側面?zhèn)让?稱重器稱重器管線光線監(jiān)測器管線光線監(jiān)測器( line sensor)血液管道空氣監(jiān)測器血液管道空氣監(jiān)測器(BL

3、AD)獻血員流量指示燈獻血員流量指示燈Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 一:顯示屏.操作面板Copyright 200

4、7 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 二: 離心機Copyright 2007 Haemonetics Corporation. Haemoneti

5、cs, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 三:閥門Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, Or

6、thoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 四:泵血液泵血液泵復合泵識別窗復合泵識別窗傳輸泵傳輸泵抗凝劑抗凝劑(AC) 泵泵Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, Orth

7、oPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 五:稱重臂Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harm

8、ony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 六:壓力監(jiān)測器獻血員壓力監(jiān)測器獻血員壓力監(jiān)測器(DPM)系統(tǒng)壓力監(jiān)測器系統(tǒng)壓力監(jiān)測器(SPM)Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction

9、 Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 七:管道空氣監(jiān)測器血液管路空氣監(jiān)測器血液管路空氣監(jiān)測器(BLAD)獻血員管路空氣監(jiān)測器獻血員管路空氣監(jiān)測器(DLAD)抗凝劑管路空氣監(jiān)測器抗凝劑管路空氣監(jiān)測器(ALAD)AC 滴注監(jiān)測器滴注監(jiān)測器Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, car

10、dioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 八:光學監(jiān)測器杯光電杯光電(O.S)管路監(jiān)測器管路監(jiān)測器(L.S)Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, C

11、ell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 九:耗材Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, Sma

12、rtSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 開機死機 屏幕只顯示“MCS+”就停止 原因原因: 經(jīng)常發(fā)生在需要更換不同程序卡經(jīng)常發(fā)生在需要更換不同程序卡.由于前一次程序結束由于前一次程序結束后未自檢就關機后未自檢就關機. 處理處理: 換回前一次采集程序卡換回前一次采集程序卡,重新啟動機器重新啟動機器,等機器自檢通等機器自檢通過結束過結束.Copyri

13、ght 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 開機自檢失敗 原因原因: 開機之前已預先安裝了耗材開機之前已預先安裝了耗材. 處理處理: 拔掉拔

14、掉DPM,SPM.取下各監(jiān)測器和閥門內的管道及稱重取下各監(jiān)測器和閥門內的管道及稱重器上的血漿袋器上的血漿袋.Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countrie

15、s, or both. 開機出現(xiàn)“The power has been off for a short time” 提示.不自檢.(code 375)原因原因: 由于停電或非正常終止采集程序由于停電或非正常終止采集程序(例例:漏液漏液,獻血員不適獻血員不適)關閉電源關閉電源.操作人員在重新安裝一套新耗材后操作人員在重新安裝一套新耗材后,沒有仔細認真的閱讀屏幕上顯示沒有仔細認真的閱讀屏幕上顯示的內容的內容,習慣地按習慣地按“ YES”,選擇了選擇了“恢復原操作程序恢復原操作程序”,使程序無法進使程序無法進行行處理處理: 重新開機重新開機,開機自檢后屏幕將提示你選擇開機自檢后屏幕將提示你選擇: 1

16、.按按“NO”鍵鍵, 已更換了新的耗材已更換了新的耗材. 2.按按“YES”鍵鍵, 原耗材未被取下原耗材未被取下,需要繼續(xù)原有采集程序需要繼續(xù)原有采集程序.Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in

17、 the USA, other countries, or both. 離心艙清理原因原因:1.漏液監(jiān)測器經(jīng)常報警漏液監(jiān)測器經(jīng)常報警. 2.離心杯安裝不到位離心杯安裝不到位. 漏液監(jiān)測器漏液監(jiān)測器 機械卡爪機械卡爪處理處理:1.用清潔干布擦拭漏液監(jiān)測器用清潔干布擦拭漏液監(jiān)測器. 2.清理卡盤上的六個機械卡爪清理卡盤上的六個機械卡爪.Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, an

18、d SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 離心機噪音大或不運轉 原因原因: 1. 卡盤上六個機械卡爪由于曾經(jīng)發(fā)生漏液被粘住卡盤上六個機械卡爪由于曾經(jīng)發(fā)生漏液被粘住,造成離心造成離心杯未安裝到位杯未安裝到位 . 2.離心杯頸部轉動部位卡死離心杯頸部轉動部位卡死. 處理處理: 1.取出離心杯取出離心杯.確保廢液袋在最低位置確保廢液袋在最低位置,用注射器吸取蒸餾水用注射器吸取蒸餾水,反復沖洗六個

19、機械卡爪反復沖洗六個機械卡爪,直到機械卡爪恢復彈性直到機械卡爪恢復彈性.沖洗過程中沖洗過程中,隨時隨時用清潔的干毛巾吸干從爪槽內流出的水用清潔的干毛巾吸干從爪槽內流出的水.同時同時,轉動離心機甩出內部轉動離心機甩出內部的水的水,直到廢液管內流出清水為止直到廢液管內流出清水為止. 2.更換耗材更換耗材,記錄耗材型號記錄耗材型號,批號批號.Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony,

20、and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 預沖階段提示“探測到空氣”(Code 5)原因原因: 1.抗凝劑空氣探測器抗凝劑空氣探測器(ACAD)內管道未裝好內管道未裝好. 2.選擇了選擇了“鹽水補償鹽水補償”卻未連接鹽水管道卻未連接鹽水管道.處理處理: 1.重新安裝抗凝劑空氣探測器重新安裝抗凝劑空氣探測器(ACAD)中的管道中的管道. 2.重新啟動機器重新啟動機器,關閉關閉“鹽水補償鹽

21、水補償”選項選項.Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 滴液監(jiān)測器報警(Code 104)原因原因:滴注器內抗凝劑液面水平

22、錯誤滴注器內抗凝劑液面水平錯誤. 液面液面處理處理: 1.液面太高液面太高,監(jiān)測器檢測不到滴液狀態(tài)監(jiān)測器檢測不到滴液狀態(tài).應將抗凝劑袋取下倒轉應將抗凝劑袋取下倒轉,擠壓滴注器擠壓滴注器,把一些把一些抗凝劑擠回抗凝劑袋抗凝劑擠回抗凝劑袋. 2.液面太低液面太低,滴液會濺起水珠滴液會濺起水珠,引發(fā)監(jiān)測器檢測滴液計數(shù)太多的錯誤引發(fā)監(jiān)測器檢測滴液計數(shù)太多的錯誤.應擠壓滴注器應擠壓滴注器,升高液面至滴注器升高液面至滴注器1/3處處.同時橫放轉動同時橫放轉動,去掉壺壁上的液滴去掉壺壁上的液滴.Copyright 2007 Haemonetics Corporation. Haemonetics, Info

23、nal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 采集過程中,按了“STOP”鍵.離心機剎車. 屏幕顯示“READY”.原因原因: 1.獻血員不適應獻血員不適應.需要終止程序需要終止程序. 2. 操作操作.處理處理: STOP STOP No Ye

24、s 按按“YES”,還輸杯內容物還輸杯內容物(不還輸血漿不還輸血漿)后結束后結束 按按”NO”,立即終止程序立即終止程序當離心杯中全血量超過當離心杯中全血量超過1/3時時: 1.按按“RETURN”鍵鍵.使杯全血還輸給獻血員使杯全血還輸給獻血員. 2.要繼續(xù)采集程序要繼續(xù)采集程序, 因此刻離心機已停轉因此刻離心機已停轉,杯中已無分層杯中已無分層.如按如按“DRAW”鍵后會同時啟動采血鍵后會同時啟動采血泵和離心機泵和離心機,全血進入杯中推出未分層的全血全血進入杯中推出未分層的全血,造成成品污染造成成品污染.此時應立即按此時應立即按“PUMP STOP”鍵鍵,待杯待杯中全血充分分層后再按中全血充分

25、分層后再按“PUMP START”鍵繼續(xù)采集鍵繼續(xù)采集.DPMLDPREADYReady to Go19545475Cycleml Plasmaml Plateletml ProcessedREADYSTOPPress STOP to return to the READY mode.PROCESS PROBLEMTERMINATE PROCEDURE NOW?Press YES to end procedure.Press NO to return to the READY mode.LDPSTOP366Press STOP to return to the READY mode.PROCE

26、SS PROBLEMTERMINATE PROCEDURE NOW?Press YES to return bowl content and end.Press NO to end the procedure immediately.LDPSTOP367Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or re

27、gistered trademarks of Haemonetics Corporation in the USA, other countries, or both. 采集(DRAW)過程中按了回輸(RETURN)鍵如果采集循環(huán)中按了回輸鍵如果采集循環(huán)中按了回輸鍵, 屏幕顯示以下信息屏幕顯示以下信息:此狀態(tài)下此狀態(tài)下,離心機保持運轉離心機保持運轉. 離心機的工作狀態(tài)取決于操作人員的決定離心機的工作狀態(tài)取決于操作人員的決定: 1.按按“Return”啟動回輸程序啟動回輸程序(回輸結束后繼續(xù)下一循環(huán)采集回輸結束后繼續(xù)下一循環(huán)采集,除非此時已處于最后的循環(huán)除非此時已處于最后的循環(huán).2:按按“Sav

28、e” 鍵把杯中物回輸并結束程序鍵把杯中物回輸并結束程序.3:按按“Draw”鍵恢復采集程序鍵恢復采集程序.Press NO to mute the alarm.PROCESS PROBLEMINITIATE RETURN NOW?Press RETURN to initiate return cycle.Press SAVE to return bowl content and end.Press DRAW to resume draw cycle.LDPSTOP368Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, c

29、ardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 避免采血針頭的堵塞 原因原因: 采血針頭至三通是沒有抗凝劑的采血針頭至三通是沒有抗凝劑的 處理處理: 在采集過程中如遇到機器故障或操作故障時在采集過程中如遇到機器故障或操作故障時,應先夾應先夾閉三通至空氣監(jiān)測器

30、之間的全血管道閉三通至空氣監(jiān)測器之間的全血管道,再順時針手動旋轉再順時針手動旋轉抗凝劑抗凝劑(AC)泵泵,讓抗凝劑進入針頭部位讓抗凝劑進入針頭部位.Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the

31、 USA, other countries, or both. 堵針的處理 原因原因: 各種因素造成的堵塞針頭各種因素造成的堵塞針頭. 處理處理: 按按“PUMP STOP”鍵鍵,停止采血泵停止采血泵,但離心機不停但離心機不停,這這樣不會影響全血在杯中的離心分層樣不會影響全血在杯中的離心分層.待處理完針頭堵塞問待處理完針頭堵塞問題后題后,再按再按“PUMP START”繼續(xù)程序繼續(xù)程序. “PUMP STOP”不不應超過應超過23分鐘分鐘.Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell

32、Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 液流不暢,造成DPM報警 原因原因: 1.針頭貼壁針頭貼壁. 2.穿刺失敗穿刺失敗. 3.管道扭壓管道扭壓. 4.針頭是否堵塞，產(chǎn)生血腫針頭是否堵塞，產(chǎn)生血腫. 5.袖帶有無充氣，是否打折袖帶有無充氣，是否打折. 處理處理: 1.檢查采血管

33、道是否存在扭曲或夾閉檢查采血管道是否存在扭曲或夾閉. 2.重新穿刺重新穿刺.Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. SPM報

34、警 原因原因: 離心杯出口至成品袋之間管道閉塞離心杯出口至成品袋之間管道閉塞.扭曲或被夾閉扭曲或被夾閉.未正確安裝未正確安裝管道管道. 處理處理: SPM高壓報警高壓報警 1.檢查離心杯出口至成品袋管道有無閉塞檢查離心杯出口至成品袋管道有無閉塞.扭曲或夾閉扭曲或夾閉. 2.檢查閥門內的管道是否顏色相符檢查閥門內的管道是否顏色相符. 3.如如SPM濾器被打濕濾器被打濕,則產(chǎn)品保存期為則產(chǎn)品保存期為24小時小時. SPM低壓報警低壓報警 1.檢查管道是否閉塞檢查管道是否閉塞.扭曲或夾閉扭曲或夾閉. 2.檢查透明閥門內是否裝載空氣采集袋管道檢查透明閥門內是否裝載空氣采集袋管道. 3.檢查采集袋是否有

35、癟縮檢查采集袋是否有癟縮.Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 溶液袋監(jiān)測(Code 394)原因原因: 機器監(jiān)測所使用的

36、溶液量機器監(jiān)測所使用的溶液量,并隨時與操作人員輸入的溶液容量比并隨時與操作人員輸入的溶液容量比對對.處理處理: 操作人員根據(jù)需要和可能操作人員根據(jù)需要和可能,按按“Return” 繼續(xù)或按繼續(xù)或按“HELP”鍵進鍵進入入Haemo Update菜單菜單,修改溶液容量參數(shù)修改溶液容量參數(shù).Press NO to mute the alarm.Press HELP for more information.Press RETURN to continue.NOTICETHE AC BAG MAY BE ALMOST EMPTY.LDPRETURNReturning cells394Copyrigh

37、t 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 血小板峰值太低PPTS(Code386)原因原因: 采前血小板計數(shù)低采前血小板計數(shù)低150*10e3

38、/ul.則可能有血小板聚集則可能有血小板聚集,在白膜層不能有效分在白膜層不能有效分離血小板離血小板.處理處理: 按按“NO”鍵終止程序鍵終止程序. 按按“YES”鍵繼續(xù)采集鍵繼續(xù)采集,此時機器停止自動監(jiān)控此時機器停止自動監(jiān)控,必須采用全程人工監(jiān)控和操必須采用全程人工監(jiān)控和操作作(DRAW,RETURN),增加循環(huán)數(shù)增加循環(huán)數(shù),防止紅細胞溢出防止紅細胞溢出.PLATELET PEAK TOO SMALLPress YES for more cycles.Press NO to end procedure.LDPRETURNReturning cells386Copyright 2007 Haem

39、onetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 血小板峰值太低PPTS 信息 This message is displayed when the optical sen

40、sor of the device detected a significant decrease in the platelet yield extracted in one pass.ACTION檢查檢查LS中管路是否正確安裝中管路是否正確安裝.通常獻血員通常獻血員PLT計數(shù)太低和計數(shù)太低和HCT太高太高,會發(fā)生這種情況會發(fā)生這種情況. 在這種情況下在這種情況下.降低采集降低采集(DRAW)泵速泵速,持續(xù)保持監(jiān)測避免紅細胞溢出持續(xù)保持監(jiān)測避免紅細胞溢出.如果如果PPTS 信息出現(xiàn)在信息出現(xiàn)在1-7循環(huán)循環(huán), 推薦繼續(xù)完成程序推薦繼續(xù)完成程序 (press YES). PPTS報警會重復出現(xiàn)

41、在以后的循環(huán)報警會重復出現(xiàn)在以后的循環(huán), 操作人員必須隨時監(jiān)測程序過程操作人員必須隨時監(jiān)測程序過程 (press YES) 或或 終止程序終止程序 (press NO).如果如果 PPTS 信息出現(xiàn)在第信息出現(xiàn)在第8個個或最后或最后循環(huán)循環(huán),終止程序終止程序 (press NO).隨時監(jiān)測避免紅細胞溢出隨時監(jiān)測避免紅細胞溢出.BackNextMenuCopyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Ha

42、rmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 造成PPTS的可能原因正常濃度和計數(shù)的血小板在經(jīng)過正常濃度和計數(shù)的血小板在經(jīng)過LS時會造成很多散射光時會造成很多散射光 LS接接收的信號會急劇下降收的信號會急劇下降Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver,

43、 OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 造成PPTS的可能原因PLT計數(shù)小或隨計數(shù)小或隨PLT的逐漸降低的逐漸降低,經(jīng)過經(jīng)過LS管路的散射光就越少管路的散射光就越少 LS接收的光信號就越強接收的光信號就越強Copyright 2007 Haemonetics Corporation. Hae

44、monetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 造成PPTS的可能原因PLT正常計數(shù)正常計數(shù),但有但有PLT聚集也會造成聚集也會造成經(jīng)過經(jīng)過LS管路的散射光減少管路的散射光減少 LS接收的光信號就越強接收的光信號就越強

45、Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. PPTS 可能會造成紅細胞溢出010203040506070809010011012

46、01301401501601701801902002102202302402500500100015002000250029123012311232123312Time sBlood + recirc pump rate ml/min0102030405060708090100110120B.O. & L.S output (%)Platelet peak too small Condition“Pink” terminationCopyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell S

47、aver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 疑有紅細胞溢出(Code 387)原因原因: 1.獻血員的篩選獻血員的篩選.采集之前應注意獻血員的血常規(guī)數(shù)據(jù)采集之前應注意獻血員的血常規(guī)數(shù)據(jù). PLT (血小板血小板)計數(shù)計數(shù)1.5*10e11. MPV(血小板平均體積血小板平均體積)7.5

48、8.5fl.觀察觀察PLT直方圖直方圖,是否單峰左移是否單峰左移.異常形態(tài)異常形態(tài)PLT會造成采集失敗會造成采集失敗(量少量少) HCT( 紅細胞壓積紅細胞壓積) 36%45%. RDW(紅細胞體積分布寬度紅細胞體積分布寬度)8%15%, MCV(紅細胞平均體積紅細胞平均體積)80100fl. MCH(平均紅細胞血紅蛋白含量平均紅細胞血紅蛋白含量)2734pg, MCHC(平均紅細胞血紅蛋白濃度平均紅細胞血紅蛋白濃度)300360g/l. Hb(血紅蛋白血紅蛋白) 120g/l160g/l獻血員近期是否獻過全血獻血員近期是否獻過全血. 采集過程中注意觀察是否存在乳糜漿和血小板聚集采集過程中注意

49、觀察是否存在乳糜漿和血小板聚集SUSPECTED RED CELL SPILLAGEInspect product.If confirmed,clamp off collected product and perform full QC.Press YES for more cycles.Press NO to end procedure.LDPRETURNReturning cells387Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSu

50、ction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 疑有紅細胞溢出(Code 387) 原因原因: 2.采集的環(huán)境因素采集的環(huán)境因素. 3.機器的工作環(huán)境機器的工作環(huán)境. 4.耗材安裝的因素耗材安裝的因素. 5.機器的保養(yǎng)機器的保養(yǎng). 6.操作的因素操作的因素.Copyright 2007 Haemonetics Corporation.

51、 Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 疑有紅細胞溢出(Code 387) 處理處理: 1.獻血員血小板計數(shù)獻血員血小板計數(shù)1.5*10e11,應判斷決定應判斷決定“繼續(xù)繼續(xù)或終止或終止”采集步驟采集步

52、驟.如繼續(xù)如繼續(xù),則增加循環(huán)數(shù)則增加循環(huán)數(shù).降低血小板的輸降低血小板的輸入?yún)?shù)入?yún)?shù).同時觀察白膜層同時觀察白膜層(Buffy Coat)的寬窄的寬窄. 2.紅細胞壓積紅細胞壓積(HCT)高會減少處理量高會減少處理量,應在采集前多飲應在采集前多飲水水,降低血液黏稠度降低血液黏稠度. 3.幼小紅細胞幼小紅細胞.會混入或接近血小板層會混入或接近血小板層,使管線監(jiān)測器使管線監(jiān)測器難以辨別難以辨別.Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuc

53、tion, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both. 疑有紅細胞溢出(Code 387) 處理處理: 4.血小板聚集血小板聚集.適當增加抗凝劑比例適當增加抗凝劑比例,注意觀察注意觀察.5.發(fā)生乳糜漿時發(fā)生乳糜漿時,應停止程序應停止程序. 6.舒適的采集環(huán)境舒適的采集環(huán)境,人性化的臨床護理人性化的臨床護理,能有效緩解獻能有效緩解獻血員的緊張心理

54、血員的緊張心理,避免因緊張而引起的成份分離不充分避免因緊張而引起的成份分離不充分.7.機器的工作環(huán)境要求機器的工作環(huán)境要求. 環(huán)境溫度環(huán)境溫度:+18 27 . 儲藏環(huán)境濕度儲藏環(huán)境濕度:90%5%.無凝露無凝露Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT, SmartSuction, SmartSuction Harmony, and SmartSuction Solo are trademarks or registered trademarks o

55、f Haemonetics Corporation in the USA, other countries, or both. 疑有紅細胞溢出(Code 387) 處理處理: 8.管路探測器管路探測器(Line sensor)內管道應正確安裝內管道應正確安裝. 9.管路探測器和杯光電探測器需要清潔和保養(yǎng)管路探測器和杯光電探測器需要清潔和保養(yǎng).10.操作人員在按了操作人員在按了“STOP”鍵后鍵后,應按照正確的操作步驟重應按照正確的操作步驟重啟采集程序啟采集程序. 按按“RETURN”鍵回輸完成后鍵回輸完成后,再按再按“DRAW”鍵繼續(xù)鍵繼續(xù)下一個循環(huán)下一個循環(huán). 或按或按“DRAW”鍵后鍵后,立即按立即按“PUMP STOP”鍵鍵,讓離心杯中全血充分離心分層讓離心杯中全血充分離心分層,再按再按“PUMP START”鍵繼續(xù)程鍵繼續(xù)程序序.機器的日常保養(yǎng)及維護機器的日常保養(yǎng)及維護Copyright 2007 Haemonetics Corporation. Haemonetics, Infonal, cardioPAT, Cell Saver, OrthoPAT,