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無血手術.
無血手術或無血外科手術,是一種外科醫學的技術,其主要目的,在於令到手術時病人的出血量減至最低,以盡可能避免因為傷口過大,令病人失血過多而需要輸血。此技術更可完全避免因輸血而產生的感染和并发症之危險。
起源
過去以來,西方醫學界都對手術中引起病人失血的情形不太重視,因為病人可以透過輸血而維持血液供應。但隨著知悉耶和華見證人基於信仰理由,所採取不輸血的堅定宗教立場,及後真的有其信徒被送到美國的醫院,要求院方使用輸血療法以外的醫療方法。這一度使院方尷尬;另一方面,他們不能因為手術令病人失血過多而致死。事實上,當時醫學界除了輸血以外,仍未有其他更好的醫療方法。由於引起了醫學界的注意,其後便出現了無血手術。[1]隨著醫學界開始關注實際需要增加、血源紧张、输血所带来的潜在危險和醫療成本等因素,無血外科手術的需求便越益增加。[2]
在1960年代早期,美國心臟外科醫生丹頓·庫利為耶和華見證人的患者成功作了數起無血心臟直視手術。15年後,他與同事發表了一份報告,表明心臟外科手術可以不輸血而安全實施。[3]
血液代替品和自體造血
早期的研究曾嘗試尋找一些取代血液的代替品,其中有鹽水和人工血。不過,人造血的造價高昂,不是所有病人能負擔。另一方面,醫學界同時嘗試讓身體自行産生血液,例如有紅細胞生成素、含鐵質的補充劑等等。
手術技術的改良
但其實,隨著醫療技術不斷的創新和改良,有不少工具都可以使手術過程簡化,以及使手術的傷口變得更少。當中最重要的發明有以下幾項:
术後
- 避免手術导致的出血现象
- 手術傷口痛感很小
- 避免血肿和各種輸血感染等并发症出现
- 住院期比輸血手術更短
- 身體迅速恢复,可很快恢复日常生活
參考來源
- ^ 美國之音:無血外科手術在美國醫院日益普及
- ^ 《艾滋病、性 和伦理学》输血问题 互联网档案馆的存檔,存档日期2005-02-12.
- ^ Ott DA, Cooley DA. Cardiovascular surgery in Jehovah's Witnesses. Report of 542 operations without blood transfusion. JAMA. 1977;232:1256-1258.
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