Thong Tu Huong Dan Hoat Dong Truyen Mau So 26.2013.Tt .Byt 16.9.13

7/24/2019 Thong Tu Huong Dan Hoat Dong Truyen Mau So 26.2013.Tt .Byt 16.9.13

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B Y T CNG HA X HI CH NGHA VIT NAMc lp - T do - Hnh phc

S:26/2013/TT- BYT H Ni, ngy 16 thng 9 nm 2013

THNG T

Hng dn hot ng truyn mu

Cn c Ngh nh s 63/2012/N-CP ngy 31 thng 8 nm 2012 ca Chnhph quy nh chc nng, nhim v, quyn hn v c cu t chc ca B Y t;

Theo ngh ca Cc trng Cc Qun l Khm, cha bnh v V trngV Php ch;

B trng B Y t ban hnh Thng t hng dn hot ng truyn mu.

Chng I

QUY NH CHUNG

iu 1. Phm vi iu chnh

1. Thng t ny hng dn hot ng chuyn mn, k thut truyn mu,bao gm: tuyn chn ngi hin mu, ly mu, xt nghim, iu ch, bo qun,vn chuyn, qun l, s dngmu v ch phm mu trong iu tr; gim st nguyc trong truyn mu; Hi ng truyn mu ti c s khm bnh, cha bnh; lugi h s v ch bo co.

2. Thng t ny khng iu chnh cc hot ng tuyn truyn, vn nghin mu; cc sn phm c tch chit t huyt tng, khng th n dng,

protein ti t hp; ghp m, b phn c th ngi vt bo gc.

iu 2. Gii thch t ng

Trong Thng t ny, cc t ng di y c hiu nh sau:

1.Ngi hin mul ngi iu kinhin mu theo quy nh ti Thngt ny v t nguyn hin mu ton phn hoc mt s thnh phn mu.


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2. Thnh phn mu l mt hoc mt s loi t bo mu v hoc huyt

tng c ly trc tip t ngi hin mu bnggn tch v c chng ng.3. Mu ton phnl mu c ly t tnh mch ngi hin mu c cha

cc loi t bo mu, huyt tng v c chng ng.

4. Gn tch (apheresis) thnh phn mul k thut ly mt hoc nhiuthnh phn mu trc tip t ngi hin thnh phn mu.

5. Ch phm mu l sn phm c iu ch ti c s truyn mu, gmmt hoc nhiu loi t bomu, huyt tng c ngun gc t mu ton phn hocthnh phn mu.

6. Ti mu (n v mu) l mt th tch mu hoc ch phm mu cng trong ti ring bit.

7.Phng cch xt nghiml trnh t thc hin cc xt nghim vi mt thp cc loi sinh phm c th c la chn theo tng mc ch xt nghim.

8.iu ch trong h thng knl vic s dng k thut to ra ch phmmu, trong n v mu c ng trong b ti gm nhiu ti gn sn vi nhau,khng ct ni hoc vic ct ni dy cc ti mu c thc hin bng thit b ct

ni t ng v trng.9. Pooll vic trn cc ch phm mu cng loi t nhiu n v mu, nhm

chun b mu xt nghim hoc bo m liu iu tr.

iu 3. Nguyn tc thc hin hot ng truyn mu

1. V mc ch nhn o,khng v mc ch li nhun.

2. Bo m t nguyn i vi ngi hin mu; khng p buc ngi khchin mu, thnh phn mu.

3. Ch s dng mu v cc ch phm mu phc v cha bnh, o to,nghin cu khoa hc.

4. Gi b mt cc thng tin c lin quan n ngi hin mu, ngi nhnmu v ch phm mu.

5. Bo m an ton cho ngi hin mu, ngi bnh c truyn mu, chphm muv nhn vin y t c lin quan.

6. Thc hin truyn mu hp l i vi ngi bnh.


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Chng II

TUYN CHN NGI HIN MU V LY MU

Mc 1IU KIN HIN MU

iu 4. Tiu chun ngi hin mu

Ngi hin mu l ngi c tiu chunv tui, sc khe v cc iukin khc, c th nh sau:

1. Tui: t 18 tui n 60 tui.2. Sc khe:

a) Ngi c cn nng t nht l 42kg ivi ph n, 45 kg i vi namgiic php hin mu ton phn; ngi c cn nng t 42 kg n di 45 kgc php hin khng qu 250 ml mu ton phn mi ln; ngi c cn nng 45kg tr ln c php hin mu ton phn khng qu 09 ml/kg cn nng v khngqu 500ml mi ln.

b)Ngi c cn nng t nht l 50 kg c php hin cc thnh phn mu

bng gn tch; ngi hin mu c th hin mt hoc nhiu thnh phn mu trongmi ln gn tch, nhng tng th tch cc thnh phn mu hin khng qu 500 ml;

Ngi c cn nng t nht l 60 kg c php hin tng th tch cc thnh phnmu hin mi ln khng qu 650 ml.

c) Khng mc cc bnh mn tnh hoc cp tnh v thn kinh, tm thn, hhp, tun hon, tit niu, tiu ho, gan mt, ni tit, mu v t chc to mu, bnhh thng, bnh t min, tnh trng d ng nng; khng mang thai vo thi imng k hin mu (i vi ph n); khng c tin s ly, hin, ghp b phn c thngi; khng nghin ma tu, nghin ru; khng c khuyt tt nng v khuyt ttc bit nng theo quy nh ti Lut Ngi khuyt tt; khng s dng mt s thucc quy nh ti Ph lc 1 ban hnh km theo Thng t ny; khng mc cc bnhly truyn qua ng mu, cc bnh ly truyn qua ng tnh dc ti thi imng k hin mu;

d) Lm sng:

- Tnh to, tip xc tt;

- Huyt p tm thu trong khong t 100 mmHg n di160 mmHg v

tm trng trong khong t 60 mmHg n di100 mmHg;


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-Nhp tim u, tn s trong khong t 60 lnn90 ln/pht;

- Khng c mt trong cc biu hin sau: gy, st cn nhanh (trn 10% cnnng c th trong thi gian 6 thng); da xanh, nim mc nht; hoa mt, chng mt;v m hi trm; hch to xut hin nhiu ni; st; ph; ho, kh th; tiu chy; xuthuyt cc loi; c cc tn thng, du hiu bt thng trn da.

) Xt nghim:

- i vi ngi hin mu ton phn v hin cc thnh phn mu bng gntch: nng hemoglobin phi t t nht bng 120 g/l; nu hin mu ton phnth tch trn 350 ml phi t t nht 125 g/l.

- i vi ngi hin huyt tng bng gn tch: nng protein huytthanh ton phn phi t t nht bng 60g/l v c xt nghim trong thi giankhng qu 01 thng;

- i vi ngi hin tiu cu, bch cu ht, t bo gc bng gn tch: slng tiu cu phi ln hn hoc bng 150109/l.

3. Ngoi cc tiu chun quy nh ti Khon 1, Khon 2 iu ny, vic chin mu do bc s khm tuyn chn ngi hin mu xem xt, quyt nh.

iu 5. Tr hon hin mu

1. Nhng ngiphi tr hon hin mu trong 12 thng k t thi im:

a) Phchi hon ton sau cc can thip ngoi khoa;

b) Khi bnh sau khi mc mt trong cc bnh st rt, giang mai, lao, unvn, vim no, vim mng no;

c) Kt thc t tim vc xin phngbnh di sau khi b ng vt cn hoctim, truyn mu, ch phm mu v cc ch phm sinh hc ngun gc t mu;

d) Sinh con hoc chm dt thai nghn.

2. Nhng ngiphi tr hon hin mu trong 06 thng k t thi im:

a) Xm tr trn da;

b) Bm di tai, bm mi, bm rn hoc cc v tr khc ca c th;

c) Phi nhim vi mu v dch c th t ngi c nguy c hoc nhimcc bnh ly truyn qua ng mu;

d) Khi bnh sau khi mc mt trong cc bnh thng hn, nhim trng huyt,b rn cn, vim tc ng mch, vim tc tnh mch, vim tu xng, vim ty.


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3. Nhng ng phi tr hon hin mu trong 04 tun k t thi im:

a) Khi bnh sau khi mc mt trong cc bnh vim d dy rut, vimng tit niu, vim da nhim trng, vim ph qun, vim phi, si, ho g, quai

b, st xut huyt, kit l, rubella, t, quai b;

b) Kt thc t tim vc xin phng rubella, si, thng hn, t, quai b,thy u, BCG.

4. Nhng ngphi trhon hin mu trong 07 ngy k t thi im:

a) Khi bnh sau khi mc mt trong cc bnh cm, cm lnh, d ng mihng, vim hng, au na u Migraine;

b) Tim cc loi vcxin, tr cc loi c quy nh ti im c Khon 1v im b Khon 3 iu ny.

5. Mt s quy nh lin quan n ngh nghip v hot ng c th cangi hin mu: nhng ngi lm mt s cng vic v thc hin cc hot ng cth sau y ch hin mu trong ngy ngh hoc ch c thc hin cc cng vic ,hot ng ny sau khi hin mu ti thiu 12 gi:

a) Ngi lm vic trn cao hoc di su: phi cng, li cn cu, cng

nhn lm vic trn cao, ngi leo ni, th m, thy th, th ln;b) Ngi vn hnh cc phng tin giao thng cng cng: li xe but, li

tu ho, li tu thu;

c) Cc trng hp khc: vn ng vin chuyn nghip, ngi vn ngnng, tp luyn nng.

6. i vi cc trng hp khng thuc quy nh ti cc khon 1, 2, 3, 4 v5 iu ny, vic tr hon hin mu do bc s khm tuyn chn ngi hin muxem xt v quyt nh.

iu 6. Khong thi gian ti thiu gia cc ln hin mu v cc thnh

phn mu

1. Khong thi gian ti thiu gia hai ln lin tip hin mu ton phn hockhi hng cu bng gn tch l 12 tun.

2. Khong thi gian ti thiu gia hai ln lin tip hin huyt tng hochin tiu cu bng gn tch l 02 tun.

3. Hin bch cu ht trung tnh hoc hin t bo gc bng gn tch mu

ngoi vi ti a khng qu ba ln trong 07 ngy.


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4. Trng hp xen k hin mu ton phn v hin cc thnh phn mu khc

nhau cng mt ngi hin mu th khong thi gian ti thiu gia cc ln hinc xem xt theo loi thnh phn mu hin trong ln gn nht.

Mc 2KHM TUYN CHN NGI NG K HIN MU

V VIC LY MU, THNH PHN MU

iu 7. ng k v qun l thng tin hin mu, thnh phn mu

1. Ngi hin mu, thnh phn mu phi xut trnh mt trong cc loi giyt sau: giy chng minh nhn dn, h chiu, giy chng minh qun i, cng an,giy php li xe, th cng tc, th hc sinh, sinh vin, th hin muhoc giy xcnhnnhn thn do c quan, t chc, on th, chnh quyn a phng cp.

2. Ngi ng k hin mu, thnh phn mu phi in y thng tin voBng hi tnh trng sc khe ngi hin mu c quy nh ti Ph lc 2 ban hnhkm theo Thng t ny.

3. Cc c s tip nhn mu phi t chc qun l thng tin ngi hin mu theo mu h s qun lc quy nh ti Ph lc 3 ban hnh km theo Thng t

ny. Cc thng tin c nhn v ngi hin mu phi c bo mt , ch c s dngvi mc ch bo m sc khe ngi hin mu v phng nga ly truyn bnh chongi bnh nhn mu.

iu 8. Ni dung khm tuyn chnngi hin mu

1. Thc hin vic hi tin s, khm sc kho v lm cc xt nghim theoquy nh ti iu 4 Thng t ny.

2. Thc hin xt nghim nhanh HBsAg trc khi hin mu i vi nging k hin mu ln u.

3. Khng bt buc thc hin xt nghim nhanh HBsAg khi khm tuyn chn i vi ngi ng k hin mu nhc li c kt qu xt nghim HBsAgsng lc n v mu ln hin trc gn nht khng phn ng hoc c kt qu xtnghim HBsAg m tnh trong ln khm sc khe gn nht trong thi gian12 thngtnh n ngy ng khin mu.

4. Trng hp ngi c tin s nghi ng HBsAg dng tnh mun hinmu, phi c kt qu m tnh trong hai ln xt nghim HBsAg lin tip cch nhau06 thng bng k thut ELISA hoc ha pht quang v ng thi thc hin xtnghim bng k thut sinh hc phn t.


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iu 9. Vic ly mu ton phn, thnh phn mu

1. Trc khi ly mu, thnh phn mu phi kim tra, i chiu chng loi,hn s dng, s nguyn vn v thnh phn chng ng ca ti ly mu (bao bng mu).

2. Ti ly mu phi c gn m s theo quy nh ti Khon 3 iu 21Thng t ny.

3. Vic ly mu phi bo m v trng, an ton cho ngi hin mu.

4. Th tch mu ly theo quy nh ti im a v im b Khon 2 iu 4Thng t ny v phi ph hp vi lng dung dch chng ng c sn trong ti ly

mu.5. Bo m truy nguyn c cc thng tin lin quan n n v mu,

thnh phn mu: m s, th tch mu thc t, thi im, thi gian, tn nhn vinly mu, thnh phn mu.

6. Trng hp th tch mu ly t hoc nhiu hn 10% so viquy nh chomi loi ti ly mu hoc c cc bt thng khc trong qu trnh ly mu, nhnvin ly mu phi ghi cnh bo trn ti mu bng bt mc bn mu hoc dn nhnring xem xt v x lring.

iu 10. Yu cu i vi vic ly mu mu xt nghim

1. Cc mu mu dng cho cc xt nghim phi c ly t ngi hin mucng thi im ly mu, thnh phn muhoc ly trc tip t ti mu, ti thnh

phn mu.

2. Mu mu phi c gn m s tng ng vi m s ca ti mu, thnhphn mu c ly theo quy nh ti Khon 2 iu 9 Thng t ny.

iu 11. X l n v mu, thnh phn mu ngay sau ly mu

Cc n v mu, thnh phn mu phi c ng gi, vn chuyn trongiu kin nhit ph hp vi mc ch s dng theo quy nh ti iu 20 Thngt ny.

Mc 3BO M QUYN LI CA NGI HIN MU

iu 12. Quyn li ca ngi hin mu

1. c cung cp thng tin v cc du hiu, triu chng bnh l do nhimcc vi rt vim gan, HIV v mt s bnh ly truyn qua ng mu khc.


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2. c gii thch v quy trnh ly mu, cc tai binkhng mong mun c

th xy ra, cc xt nghim s thc hin trc v sau khi hin mu.3. c bo m b mt v kt qu khm lm sng, kt qu xt nghim;

c t vn v cc bt thng pht hin khi khm sc kho, hin mu; chng dn cch chm sc sc kho; c t vn v kt qu xt nghim bt thngtheo quy nh ti Khon 4 iu 17 Thng t ny.

4. c chm sc, iu tr khi c cc tai bin khng mong mun xy ratrong v sau hin mu theo quy nh ti Ph lc 4 ban hnh km theo Thng tny. c h tr chi ph chm sc, iu tr khi c cc tai bin khng mong munxy ra trong v sau hin mu. Kinh ph h tr chm sc iu tr ngi hin mutheo quy nh ti Khon ny c thc hin theo quy nh ca php lut.

5. c c quan c thm quyn xem xt, quyt nh tn vinh, khen thngvbo mcc quyn li khc v tinh thn, vt cht ca ngi hin mu theo quynh ca php lut.

Chng IIIXT NGHIM CC N V MU TON PHN

V THNH PHN MU

iu 13. Nguyn tc xt nghim

1. Phi thc hin xt nghim sng lc cho mi n v mu, thnh phnmu. Khng c quy chiu kt qu xt nghim thc hin t trc hoc cc lnhin mu trc ca ngi hin mu cho n v mu, thnh phn mu mi hin, trtrng hp quynh ti Khon 3 iu 15 Thng t ny.

2. Chn la, s dng cc thuc th, sinh phm, dng c, thit b xt nghim

bo m cht lng xt nghim sng lc n v mu theo quy nh ca php lut.Thc hin kim sot cht lng sinh phm, kim tra cht lngxt nghim.

3. Thc hin cc quy trnh xt nghim,phng cch xt nghim, phn tchkt qu ph hp visinh phm, trang thit b, dng c hin c v c lnh on vthc hin xt nghim ph duyt.

4. Thc hin xt nghim sng lc cc tc nhn ly truyn qua ng mucho n v mu, thnh phn mu phi bo mcc yu cu sau:

a) Mu mu xt nghim phi cng ngun gc vi n v mu, thnh phn

mu theo quy nh ti iu 10 Thng t ny;


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b) C th truy tm ti mu t mu mu v ngc li truy tm mu mu t

ti mu;c) Thc hin xt nghim theo phng cch bo m nhy, phng nga

nguy c m tnh gi v c lnh on vph duyt;

d) Kt qu xt nghim sng lc cc tc nhn ly truyn qua ng mu chon v mu, thnh phn mu ch c dng kim sot an ton cho n v mu,thnh phn mu nhm phng nga ly nhim cc tc nhn ly truyn qua ngmu v khng c s dng tr li, t vncho ngi hin mu.

5. Khi ly mu t ngi hin mu nhiu ln, phi i chiu vi kt qu xt

nghim ca n v mu hin ln gn nht trc . Trng hp cc kt qu xtnghim c s khc nhau hoc nghi ng nhm ln mu xt nghim hoc nhm lnh s, phi xt nghim li vi mu ly trc tip t n v mu, thnh phn mu.

6. Khi thc hin xt nghim khng nh v cc tc nhn ly truyn quang mu cho ngi hin mu phi bo mcc yu cu sau:

a) Xc minh chnh xc nhn thn ngi c ly mu lm xt nghim;

b) Thc hin xt nghim theo phng cch bo m c hiu, phngnga nguy c dng tnh gi v c cp c thm quynph duyt;

c) Kt qu xt nghim khng nh ch c dng tr li, t vn sc khecho ngi hin mu v khng c dng kim sot an ton cc n v mu,thnh phn mu.

iu 14. Cc loi xt nghim sng lc n v mu

1. Cc xt nghim bt bucphi thc hin i vi tt c n v mu tonphn, thnh phn mu hin gm:

a) Xt nghim huyt thanh hc nhm mu: nh nhm hng cu ABO,Rh(D), sng lc khng th bt thng;

b) Xt nghim mt s tc nhn ly truyn bnh: xt nghim sng lc HIV,vim gan vi rt B, vim gan vi rt C v giang mai.

2. Ngoi cc xt nghim quy nh ti Khon 1 iu ny, phi thc hinthm mt s xt nghim trong cc trng hp sau:

a) Thc hin nh nhm h Rh(C, c, E, e)hoc cc h MNSs, Kidd, Duffy, P,Lewis khi bc s iu tr ch nh truyn mu la chn ph hp khng nguyn hng cu.

b) Xt nghim sng lc st rt i vi cc n v mu ton phn, thnh

phn mu ly t ngi hin mu ang sng, lm vic nhng vng clu hnhdch st rt theo cng b ca B Y t hoc nhng ngi mi tr v t vng dch


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st rt trong thi gian 06 thng hoc nhng ngi c tin s mc bnh st rt trongthi gian 12 thng k t khi iu tr khi bnh st rt;

c) Xt nghim CMV (Cytomegalovirus) i vi cc n v ch phm mutruyn cho ngi bnh c ghp m, ghp t bo gc hoc truyn mu cho thainhi hoc mt s trng hp c bit khc theo yu cu ca bc s iu tr.

3. Xt nghim b sung: trong mt s trng hp bo m an ton chongi bnh nhn mu, cc c s truyn mu c iu kin k thut c thchin xt nghim b sung theo ch nh ca bc s iu tr.

4. Yu cu k thut i vi cc xt nghim bt buc:

a) nh nhm mu h ABO: phi thc hin bng 2 phng php huytthanh mu v hng cu mu vi k thut ti thiu tng ng hoc cao hn kthut thc hin trong ng nghim. Nhm mu ch c kt lun khi c s ph hpkt qu ca hai phng php hoc c khng nh bng cc xt nghim b sung;

b) nh nhm mu h Rh(D): phi thc hin bng phng php huytthanh mu vi k thut ti thiu thc hin trong ng nghim. Ch c kt lunn v mu c nhm Rh(D) m, sau khi thc hin xt nghim khng nh bngxt nghim tng ng hoc cao hn k thut khng globulin gin tip;

c) Xt nghim sng lc khng th bt thng phi thc hin k thut xtnghim c kh nng pht hin cc khng th bt thng, ti thiu thuc cc hnhm hng cu Rh, MNSs, Kell, Kidd, Duffy, Lutheran theo l trnh quy nh tiiu 70 Thng t ny;

d) Xt nghim sng lc HIV: phi thc hin bng k thut c nhy, c hiu tng ng hoc cao hn k thut ELISA hoc ho pht quang vi sinh

phm c kh nng pht hin ng thi khng nguyn, khng th HIV-1 v HIV-2;

) Xt nghim sng lc vi rt vim gan B: phi thc hin xt nghim phthin khng nguyn HBsAg bng k thut c nhy, c hiu tng nghoc cao hn k thut ELISA hoc ho pht quang;

e) Xt nghim sng lc vi rt vim gan C: phi thc hin bng k thut c nhy, c hiu tng ng hoc cao hn k thut ELISA hoc ho phtquang vi sinh phm c kh nng ti thiu pht hin c khng th vim gan C;

g) Xt nghim snglc HIV-1 v HIV-2, vi rt vim gan B, vi rt vim ganC bng k thut NAT c p dng i vi tt c cc n v mu, thnh phn mu

theo l trnh quy nh ti iu 70 Thng t ny;


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h) Xt nghim sng lc giang mai: phi thc hin xt nghim pht hin

giang mai bng k thut c nhy v c hiu tng ng hoc cao hn kthutRPR;

i) Xt nghim sng lc st rt: phi thc hin xt nghim bng k thut c nhy tng ng hoc cao hn k thut tm k sinh trng st rt trn tiu bn

git c, git n v c kt qu bng knh hin vi quang hc;

k) Xt nghim CMV: phi thc hin xt nghim pht hin khng th IgM,khng CMV bng k thut c nhy tng ng hoc cao hn k thut ELISAhoc ho pht quang.

5. Th t thc hin cc xt nghim sng lc HIV, vim gan vi rt B, vimgan vi rt C, giang mai do lnh on vph duyt. Kt lun n v mu, thnh

phn mu an ton vi cc tc nhn ny phi cn c kt qu xt nghim thchin bng k thut ELISA v k thut NAThoc ha pht quang v k thut NAT.

6. Phi p dng cc bin php bo m cht lng xt nghim cc n vmu, thnh phn mu theo quy nh ti Ph lc 5 , Ph lc 6 ban hnh km theoThng t ny.

iu 15. Xt nghim sng lc cc tc nhn ly truyn bnh qua ng

mu trong trng hp c bit1. Vic xt nghim sng lc HIV-1 v HIV-2, vim gan vi rt B, vim gan

vi rt C i vi n v mu trc khi truyn bng phng php xt nghim nhanhch c thc hin khi p ng cc iu kin sau:

a) Ch p dng vi cc c s y t min ni, vng su, vng xa, bin giiv hi o;

b) Ch p dng vi cc n vmu ton phn; khng p dng vi cc nv thnh phn mu;

c) Bc s iu tr ch nh truyn mu v c ghi trong h s bnh n;

d) lin h vi c s truyn mu gn nht, nhng khng c n v muha hp hoc thi gian nhn mu t c s truyn mu gn nht khng p ng yucu cp cu ngi bnh;

) Ngi bnh hoc ngi i din hp php ca ngi bnh k xc nhn voh s bnh n v vic ng truyn n v mu ch sng lc bng xt nghim nhanh,sau khi c nhn vin y t gii thch v nguyc ly nhim bnh c th xy ra;

e) Xc nhn ca ngi ph trchkhoa, phng khm bnh, cha bnh hocngic y quyn v vic khng c n v mu ph hp lu tr ti c s khm


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bnh, cha bnh hoc khng so vi nhu cu iu tr v ghi h sbnh n xc

nhn vic cho php thc hin xt nghim nhanh ti thi im cn phi truyn mucp cu.

2. Trong trng hp p dng cc quy nh ti Khon 1 iu nyv vic xtnghim n v mu bng phng php xt nghim nhanh, cc c s khm bnh,cha bnh phi thc hin nh sau:

a) Chm nht l 24 gi k t thi im thc hin truyn n v mu chsng lc bng phng php xt nghim nhanh, c s khm bnh, cha bnh phitip tc thc hin y cc xt nghim quy nh ti iu 14 Thng t ny v

phi lu mu xt nghim theo quy nh ti iu 16 Thng t ny;

b) Trong trng hp khng c kh nng thc hin cc xt nghim theo quynh ti iu 14 v im a Khon 2 iu ny, c s khm bnh, cha bnh phi gimu huyt thanh, huyt tng ca n v mu truyn n c s khc c kh nngthc hin xt nghim theo quy nh ti iu 14 Thng t ny trong thi gian chmnht l 07 ngy k t thi im thc hin truyn mu ch sng lc bng phng

php xt nghim nhanh; phi lu mu huyt thanh ca n v mu truyn ti cs thc hin xt nghim sng lc theo quy nh ti iu 16 Thng t ny.

3. C s khm bnh, cha bnhmin ni, vng su, vng xa, bin gii v

hi o khng c kh nng thc hin xt nghim theo quy nh ti iu 14 Thngt ny v cng khng th gi n cc c s khc lm xt nghim theo quy nh tiKhon 2 iu ny, c s dng n v mu sng lc bng phng php xtnghim nhanh, khi p ng cc iu kin sau:

a) Ngi hin mu c xt nghim sng lc theo quy nh ca iu 14Thng t ny trong thi gian khng qu 12 thng tnh n thi im hin mu vicc phiu tr li kt qu xt nghim phi m tnh v c lu tr ti c s tipnhn hin mu;

b) n v mu hin phi c lm xt nghim nhanh sng lc HIV, vimgan vi rt B, vim gan vi rt C vi kt qu cc xt nghim u phi m tnh.

iu 16. Lu gi mu xt nghim

1. Phi lu gi mu huyt thanh hoc huyt tng dng xt nghim sng lc tt c cc n v mu ton phn, thnh phn mu.Lu gi on dy timu theo quy nh ti Ph lc 6 Thng t ny.

2. Mu xt nghim phi c bo qun nhit t m 18 oC (- 18oC) trxung,c m ha v lp h s qun l.

3. Mu xt nghim phi c lu gi ti c s thc hin xt nghim tithiu 02 nm k t ngy ly mu. i vi n v mu, ch phm mu c thi hn


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s dng di hn 02 nm k t khi ly mu, th thi gian lu gi mu xt nghimphi ko di thm ti thiu 01 nm tnh t thi im ht hn s dng cc n vmu, ch phm mu . B phn (t, nhm, khoa, phng) lu mu huyt thanh,huyt tng phi c lp vi b phn lm xt nghim.

iu 17. Qun l kt qu xt nghim

1. Sau khi c kt qu xt nghim, b phn xt nghim phi c trch nhimthng bo kt qu bng vn bn hoc truyn d liu in t theo cch thc clnh on vph duyt cho cc b phn c lin quan.

2.Nu cc xt nghim sng lc n v mu v tc nhn gy bnh ly quang mu c kt qu bt thng, th thc hin theo quy nh ti Ph lc 6 ban

hnh km Thng t ny.3. Trng hp xt nghim n v mu, thnh phn mu ly t ngi hin

mu nhc li c kt qu bt thngv cc tc nhn gy bnh ly qua ng mu,b phn xt nghimsng lc n v mu phixt nghim li mu mu t n vmu, thnh phn mu ca cng ngi hin mu ln hin mu trc; nu kt quxt nghim li ln hin trc c bt thng th tip tc kim tra li mu ly lnhin trc lin k, ng thi b phn xt nghim c trch nhim phi thng bocho cc b phn, n v lin quan bit cng thc hin theoquy nh ti Ph lc7ban hnh km theo Thng t ny. Vic xt nghim cho cc mu mu ca cc ln

hin trc phi s dng k thut v sinh phm c nhy cao t nht bng hoctng ng vi k thut v sinh phm thc hin ln trc.

4. Ch c thng bo kt qu bt thng cho ngi hin mu khi thchin xt nghim khng nh theo Ph lc 6 ban hnh km Thng t ny. Trongtrng hp xt nghim khng nh v HIV, phi thc hin theo quy nh hin hnhca B Y t v vic thng bo kt qu xt nghim HIV dng tnh.

Chng IVIU CH, BO QUN, VN CHUYN MU V CH PHM MU

Mc 1CC YU CU CHUNG

iu 18. Nguyn tc chung

1. Ch s dng ti ly mu, ti gn tch thnh phn mu (bao b ng mu)bo mcht lng v c ngun gc r rng.


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2. Thc hin tch cc ch phm mu trong h thng knhoc trng hpiu ch trong h thng h phi bo m thc hin quy trnh v trng.

3. ng lnh v tan ng cc ch phm huyt tng v ta lnh

a) n v huyt tng phi c ng lnh trong khong thi gian ti a 8gi k t thi im bt u vic ng lnh vi nhit t m 25 oC (-25oC) trxung;

b) Bo qun ng lnh: phi bo qun nhit duy tr t m 18oC(-18oC) tr xung;

c) Lm tan ng, m ti mu, ch phm muphi bo m cc iu kin

sau:- Khng b mt ti mu, cc v tr cm kim truyn mu tip xc trc tip

vi dung dch lm tan ng;

- Lm tan ng nhit t 30oC n 37oC trong thi gian khng qu 15pht i vi ch phm ta lnh v khng qu 45 pht i vi huyt tng nglnh;

- n v mu, ch phm mu c lm tan ng th khng c lmng lnh li.

4. Chiu x gamma cho ti mu v ch phm mu

a) Phi chiu x gamma cho ti mu v ch phm mu bt hot bch culympho phng nga nguy c bnh ghp chng ch trc khi truyn cho ngi

bnh mc chngsuy gim min dch, vi liu chiu x cho mi lt chiu phi tt nht 25 Gy (2.500 cGy);

b) Hn dng ca khi hng cu sau khi chiu x l 28 ngy v ng thiphi tun th hn dng ca khi hng cu khng chiu x cng loi, cng thigian. Hn s dng khi tiu cu khng thay i sau chiu x;

c) Phi dn nhn phn bit ti mu c chiu x vi ti mu chachiu x.

5. Cch ly v tiu hy n v mu:

a) n v mu, thnh phn mu v ton b cc n v ch phm mu chac xt nghim theo quy nh ti cc iu 14, iu 15 Thng t ny phi ccch ly,bo qun ring bit cho n khi p ng iu kin. Phng cch x lcc n v mu, thnh phn mu c kt qu xt nghim bt thng thc hin theoquy nh ti Ph lc 6ban hnh km Thng t ny.


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b) Tt c cc n v mu, ch phm mukhng an ton hoc ht hn s

dng phi c cch ly, qun l ring bit v tiu hy theo quy nh hin hnh vqun l cht thi y t.

iu 19. Thit blnh bo qun cc n v mu v ch phm mu

1. Yu cu chung v thit b lnh bo qun n v mu v ch phm mu

a) Phng t thit b lnh bo qun mu phi c bo m c in p nnh v thng kh tt;

b) Thit b lnhc khong trng trong khoang bo qun bo m lu

thng dng kh, d kim tra v quan st;c) Nhit ng u mi v tr bn trong khoang bo qun;

d) Thit b lnh phi c h thng theo di nhit p ng cc yu cusau:

- C kh nng gim st nhit ng thi bng hai phng php c lp,lin tc v lu li c thng s theo thi gian thc t bng h thng ghi nhit t ng hoc ghi th cng t nht 4 gi mt ln;

- H thng gim st nhit ca thit b lnhphi hot ng c trongtrng hp mt in ngun;

- C h thng cnh bo nhit bt thng bng m thanh, nh sng.

) Thit b lnh bo qun n v mu, ch phm mu khng c dng bo qun cc thuc th, sinh phmxt nghim, thc phm;

e) C ch bo qun ring, c nhn phn bit cho tng loi mu, ch phmmu, nh sau:

- Loi xt nghim an ton sn sng cp pht;

- Loi cha xt nghim;- Loi xt nghim v c kt qu bt thng.

2. Yu cu i vi t lnh bo qun n v mu, ch phm mu

a) Nhit bn trong khoang bo qun lun t 2oC n 6oC;

b) Bo m s ng u nhit ca khoang bo qun bng thng gi cngbc vi qut thng gi;

c) Cho php quan st c cc ti mu lu tr bn trong khoang bo qun,

m khng cn m cnh t.


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3. Yu cu i vi quy ng lnh boqun n v mu, ch phm mu

a) Nhit bn trong khoang bo qun lun c nhit t m 18 oC(-18oC) tr xung tu theo yu cu bo qun ca loi ch phmmu v quy trnhc ph duyt;

b) C kh nng nh k t ph ng dn lnh hoc phi nh k ph ngth cng bm dnh dn lnh.

4. Yu cu i vi my lc v t bo qun tiu cu

a) Nhit bn trong khoang bo qun lun t 20oC n 24oC;

b) Bo m s ng u nhit trong t bng thng gi cng bc viqut thng gi;

c) Quan st c cc ti tiu cu lu tr bn trong khoang bo qun, mkhng cn m cnh t;

d) My lc theo chiu ngang;

) C h thng bo ng khi my lc dng hot ng hoc c nhng btthng.

iu 20. Vn chuyn mu v ch phm mu

1. Thit b, phng tin vn chuyn phi duy tr c nhit ph hp viyu cu bo qun tng loi mu v ch phm mu.

2. Vic vn chuyn n v mu phi bo m an ton, kim sot, theo dic nhit v thi gian vn chuyn theo yu cu sau:

a) i vi mu tonphn v khi hng cu: bom duy tr nhit trongkhoang vn chuyn t 1oC n 10oC trong sut qu trnh vn chuyn; mu ton

phn dng iu ch khi tiu cu c bo qun, vn chuyn theo quy nh tiim b Khon 2 iu 22 Thng t ny;

b) i vi khi tiu cu v khi bch cu: bo m duy tr nhit trongkhoang vn chuyn t 20oC n 24oC;

c) i vi huyt tng v cc ch phm mu ng lnh: bo m duy trnhit trong khoang vn chuyn t m 18oC (-18oC) tr xung;

d) lnh dng bo qun khng c t tip xc trc tip vi ti mu.

iu 21. Nhn ca n v mu v ch phm mu

Ngoi vic tun th cc quy nh hin hnh v ghi nhn hng ha, nhn ca

n v mu, ch phm mu phi c nhng thng tin nh sau:


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1. Tn, a ch c s iu ch mu v ch phm.

2. Tn loi ch phm mu.3. M s ca n v mu, ch phm mu: ch c mt m s duy nht cho

php truy nguyn cc thng tin v ngi hin mu, qu trnh ly mu, sng lc,iu ch, lu tr, vn chuyn, phn phi v s dng n v mu, ch phm mu.

4. Nhm mu h ABO v Rh(D); thng tin v cc nhm mu khc (nu c).

5. Ngy, thng, nm ly mu.

6. Tn dung dch chng ng hoc dung dch bo qun (i vi mu tonphn hoc khi hng cu).

7. Ngy ht hn s dng.

8. Th tch hoc cn nng ca n v ch phm mu.

9. Nhit bo qun.

10. Ghi ch trn tt c nhn ca ti mu, ch phm mu: Cn truyn qua bdy truyn c bu lc; khng ctruyn nu c hin tng tan mu, mu sc btthng. Ring vi mu, ch phm mu chiu x, cn ghi thm: chiu x.

Mc 2TIU CHUN CA MT S CH PHM MU

iu 22. Mu ton phn

1. Tiu chun: ly t ngi hin mu c tuyn chn theo quy nh tiiu 4 Thng t ny v khng thuc cc trng hp phi tr hon hin mu theoquy nh ti iu 5 Thng t ny. Cc n v mu ton phn ny phic kt quan ton vi cc xt nghim c quy nh ti iu 14, iu 15 Thng t ny.

2. iu kin bo qun v hn s dng:a) Khi bo qun nhit t 2C n 6C , hn s dng ca mu ton phn

khng qu 21 ngy vi dung dch chng ngCitrat-Phosphat-Dextrose v khngqu 35 ngy vi dung dch Citrat-Phosphat-Dextrose-Adenin;

b) Khi bo qun nhit t 20C n 24C,hn s dng ca mu tonphn khng qu 24 gi.

3. Kim tra cht lng (c thc hin vi s lng mu ly ngu nhin theo t l t 0,1% n 1% tng s n v mu ton phn v khng t hn 05 n v

trong mi thng) v cc tiu chun sau:


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a) Th tch chnh lch khng qu 10% th tch ghi trn nhn (khng bao

gm th tch dung dch chng ng);b) Kim tra vic thc hin cc xt nghim theo quy nh ti iu 14 , iu

15 Thng t ny;

c) Nng hemoglobin ti thiu 10g trong mi th tch 100 ml mu tonphn;

iu 23. Khi hng cu m c

1. Khi hng cu m c (hng cu lng) l phn cn li camu tonphn tch huyt tng sau khi ly tm hoc lng v khng thc hin thm bt

k cng on x l no khc.2. Tiu chun v kim tra cht lng

Thc hin kim tra cht lng (vi s lng mu ly ngu nhin theo t lt 0,1 n 1% tng s n v c iu ch v khng t hn 05 n v trong mithng) v cc tiu chun sau:

a) Th tch n v khi hng cu bng 60% 15% th tch mu ton phnban u;

b) Lng hemoglobin ti thiu l 10g t mi 100ml mu ton phn ciu ch;

c) Hematocrit t 0,65 n 0,75.

3. iu kin bo qun v hn s dng: nh mu ton phn quy nh tiim a Khon 2 iu 22 Thng t ny.

iu 24. Khi hng cu c dung dch bo qun

1. L khi hng cu m c c b sung dung dch bo qun hng cu nhmci thin cht lng hng cu.

2. Tiu chun v kim tra cht lng

Thc hin kim tra cht lng (vi s lng mu ly ngu nhin theo t l0,1% n 1% tng s n v c iu ch v khng t hn 05 n v trong mi

thng) v cc tiu chun sau:

a) Phi s dng dung dch bo qun c Adenin trong thnh phn;

b) Th tch n v ch phm bng 70% 15% th tch n v mu ton phnban u;


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c) Lng hemoglobin ti thiu l 10g t mi th tch 100ml mu ton phn

c iu ch;d) Hematocrit t 0,50 n 0,70;

3. iu kin bo qun v hn s dng:

a) i vi khi hng cu c dung dch bo qun c iu ch trong hthng kn: hn s dng thc hin theo khuyn ngh ca nh sn xut ti ly mu vdung dch bo qun mu, nhng khng ko di hn 42 ngy k t thi im l ymu v bo qun nhit t 2oC n 6oC;

b) i vi khi hng cu c dung dch bo qun c iu ch trong h

thng h: ch c s dng trong khong thi gian khng qu 24 gi nu bo qun nhit t 2oC n 6oC v khng qu 6 gi nu bo qun nhit phng (t18oC n 24oC) k t khi thc hin iu chtrong h thng h.

iu 25. Khi hng cu gim bch cu

1. Khi hng cu gim bch cu l khi hng cu c tch bch cu bngphng php ly tm loi b trn 70% bch cu c trong n v mu ton phn banu.


Thc hin kim tra cht lng (vi s lng mu ly ngu nhin theo t lt 0,1% n 1% tng s n v c iu ch v khng t hn 05 n v trong mithng) v cc tiu chun sau:

a) Th tch nv khi hng cu bng 70% 15% th tch mu ton phnban u;

b) Lng hemoglobin ti thiu l 9,5g t mi 100 ml mu ton phn;

c) Hematocrit t 0,50 n 0,70;

d) S lng bch cu cn li t hn 1,2109 t mi n vkhi hng cugimbch cu. C t nht 75% s n v mu c kim tra phi t tiu chun ny;

3. iu kin bo qun v hn s dng: Khi hng cu gim bch cu c bo qun theo quy nh ti Khon 3 iu 24 Thng t ny.

4. Khi hng cu gim bch cu c dung dch bo qun: theo quy nh tiKhon 2 iu ny v iu 24 Thng t ny.

iu 26. Khi hng cu ra

1. Khi hng cu ra l khi hng cu c loi b huyt tng bng cchra nhiu ln (ti thiu 3 ln) vi dung dch mui ng trng v c pha long


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trong dung dch mui ng trng hoc trong dung dch bo qun hoc trong huyt

tng ph hp.2. Tiu chun v kim tra cht lng

Thc hin kim tra cht lng (vi s lng mu ly ngu nhin theo t l10% tng s n v c iu ch) v cc tiu chun sau:

a) Th tch n v ch phm ny bng 65% 15% th tch mu ton phnban u;

b) Nng protein trong nc ni cui cng t hn 0,5g/n v khi hngcu;

c) Lng hemoglobin ti thiu l 9,0g t mi th tch 100 ml mu ton phn

ban u;d) Hematocrit t 0,50 n 0,70;

3. iu kin bo qun v hn s dng: khi hng cu ra trong h thng h,khibo qun nhit t 2oC n 6oC hn s dng trong 24 gi; khibo qun nhit 20oC n24oC c hn s dng trong vng 6 gi k t khi kt thc iuch.Khi hng cu ra trong h thng kn, c b sung dung dch bo qun hngcu, bo qun nhit t 2oC n 6oC c hn s dng trong 14 ngy.

iu 27. Khi hng cu lc bch cu

1. Khi hng cu lc bch cu l khi hng cu c loi b bch cu bngb lc bch cu. Vic lc bch cu phi c thc hin trong thi gian 72 gi, kt khi ly mu t ngi hinmu.


Thc hin kim tra cht lng (vi s lng mu ly ngu nhin theo t l5% tng s n v c iu ch) v cc tiu chun sau:

a) Th tch n v khi hng cu bng 65% 15% th tch mu ton phn

ban u;b) Lng hemoglobin ti thiu l 9,0g t mi th tch 100 ml mu ton phn

ban u;


d) S lng bch cu cn li t hn 1,0!106trong mi n vkhi hng cu.Phi c t nht 90% s n v mu c kim tra t tiu chun ny;

3. iu kin bo qun v hn s dng: theo quy nh ti Khon 3 iu 24Thng t ny.


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iu 28. Khi hng cu ng lnh

1. Khi hng cu ng lnh l khi hngcu c bo qun ng lnh trongdung dch bo v hng cu ng lnh c glycerol v c bo qun nhit tm 60oC (-60oC) tr xung.Trc khi c truyn cho ngi bnh, khi hng cung lnh phi c lm tan ng, ra v loi b glycerol, ha long trong dungdch mui ng trng hoc b sung dung dch bo qun hng cu.


Thc hin kim tra cht lng (vi s lng mu ly ngu nhin ti thiu10% tng s n v khi hng cu ng lnh lm tan ng v loi b glycerol)

v cc tiu chun sau:a) Th tch n v khi hng cu bng 65% 15% th tch mu ton phn

ban u;

b) Lng hemoglobin ti thiu l 8,0g t mi 100ml mu ton phn ban u;


d) thm thu ti a khng cao hn 340 mOsm/l;

) Nui cy pht hin vi khun m tnh.


a) Hn s dng l 10 nm bo qun vi dung dch glycerol 40% nhit t m 80oC (-80oC) n m 60oC (-60oC);

b) Hn s dng l 10 nm bo qun vi dung dch glycerol 20% trong nitlng nhit t m 150oC (-150oC) n m 120oC (-120oC);

c) Hn s dng l 14 ngy tnh t ngy lm tan ng, ra hng cu loi bglycerol trong h thng kn v c b sung dung dch bo qun hng cu;

d) Hn s dng khng qu 24 gi nu bo qun t 2

o

C n 6

o

C v khngqu 6 gi nu bo qun nhit phng k t khi lm tan ng v ra hng culoi b glycerol trong h thng h.

iu 29. Khi tiu cu iu ch t n v mu ton phn

1. Khi tiu cu cha phn ln tiu cu c iu ch t n v mu tonphn bo qun nhit t 20oC n 24oC trong 24 gi k t khi ly mu.

2. Tiu chun v kim tra cht lngkhi tiu cu iu ch t mt n vmu ton phn.


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22

Thc hin kim tra cht lng (vi s lng mu ly ngu nhin theo t l

1% n 5% tng s n v c iu ch v khng di 10 n v trong mithng) v cc tiu chun sau:

a) Th tch n v: th tch t 40ml n 60ml iu ch t mi n v muton phn c th tch t 250ml tr ln;

b) m s lng tiu cu:c ti thiu 13109tiu cu trong n v khi tiucu iu ch t mi th tch 100 ml mu ton phn. C t nht 75% s n v muc kim tra phi t tiu chun ny;

c) m s lng bch cu trong mi n v khi tiu cu:

- t hn 0,05109bch cu i vi khi tiu cu iu ch bng phng phptch lp bch cu - tiu cu. C t nht 75% s n v mu c kim tra phi ttiu chun ny;

- t hn 0,2109bch cu i vi khi tiu cu iu ch bng phng phphuyt tng giu tiu cu.C t nht 75% s n v mu c kim tra phi ttiu chun ny;

d) pH phi t t 6,4 n 7,4 khi o nhit 22oC vo cui thi gianbo qun;

) Xt nghim nui cy pht hin vi khun phi c kt qu m tnh.

3. Tiu chun v kim tra cht lng n v pool khi tiu cu iu ch tnhiun v mu ton phn.

Thc hin kim tra cht lng (vi s lng mu ly ngu nhin theo t l1% n 5% tng s n v c iu ch v khng di 10 n v trong mithng) v cc tiu chun sau:

a) Th tch n v: th tch t 120ml n 200 ml iu ch t 1.000ml mu

ton phn;

b) m s lng tiu cu: c ti thiu 140!109 tiu cu trong mt n vkhi tiu cuiu ch t 1.000ml mu ton phn. C t nht 75% s n v ckim tra phi t tiu chun ny;

c) m s lng bch cu: t hn 1,0109bch cu trong mi n v khitiu cu;

d) pH v nui cy pht hin vi khun: theo quy nh ca im d, Khon 2 iu ny.


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4. iu kin bo qun v hn s dng

a) i vi khi tiu cu iu ch t n v mu ton phn trong h thngkn: hn s dng theo khuyn ngh ca nh sn xut ti ly mu , nhng khng qu05 ngy k t ngy ly mu v bo qun tiu cu nhit t 20oC n 24oC kmtheo lc lin tc;

b) i vi khi tiu cu iu ch t n v mu ton phn trong h thngh: hn s dng khng qu 06 gi, k t khi kt thc iu ch khi bo qun nhit t 20oC n 24oC km theo lc lin tc.

iu 30. Khi tiu cu gn tch t ngi hin mu

1. Khi tiu cu gn tch l khi tiu cu ly trc tip t ngi hin mubng my tch t bo t ng.


Thc hin kim tra cht lng (vi s lng mu ly ngu nhin theo t l10% tng s n v c gn tch) v cc tiu chun sau:

a) Th tch mi n v khng dao ng qu 15% th tch ghi trn nhn;

b) Mi n v khi tiu cu gn tch (250 ml) c s lng tiu cu ti thiu300!109; trong trng hpkhi tiu cu gn tch c th tch 120 ml n di 250

ml c s lng tiu cu ti thiu150!109;c) Nng tiu cu phi thp hn 1,5!109/ml;

d) pH phi t t 6,4 n 7,4 v nui cy pht hin vi khun phi m tnhvo cui thi gian bo qun.

3. iu kin bo qun v hn s dng: theo khuyn ngh ca nh sn xut tily tiu cu, nhng khng qu 5 ngy k t ngy gn tch tiu cu khi bo qun nhit t 20oC n 24oC, km lc lin tc.

iu 31. Khi tiu cu lc bch cu

1. Khi tiu cu lc bch cu l khi tiu cu c iu ch t mu tonphn hoc bng gn tch v c loi b bch cu bng b lc bch cu.

2. Tiu chun v kim tra cht lng: kim tra cht lng cc n v khitiu cu lc bch cu

a) Th tch mi n v dao ng khng qu 15% (15%) th tch ghi trnnhn;

b) Khi tiu cu lc bch cu c iu ch t mu ton phn: c t nht130!109 tiu cu trong n v khi tiu cu iu ch t mi 1 .000 ml mu ton

phn;


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c) Khi tiu cu lc bch cu gn tch t ngi hin mu: c t nht 300109

tiu cu vi mi lt gn tch tiu cu;d) C t hn 1106bch cu trong mt n v khi tiu cu;

) pH phi t t 6,4 n 7,4 vo cui thi gian bo qun;

e) Nui cy pht hin vi khun m tnh: kim tra tiu chun ny trong t nhtt 1% n 5% s n v iu ch. Khng cn kim tra tiu chun ny vi khitiu cu lc bch cu ngay ti ging bnh.


a) i vi khi tiu cu iu ch trong h thng kn: hn s dng theokhuyn ngh ca nh sn xut ti ly mu , nhng khng qu 05 ngy k t ngyly mu v bo qun tiu cu nhit t 20oC n 24oC km theo lc lin tc;

b) i vi khi tiu cu iu ch trong h thng h: hn s dng khng qu06 gi, k t khi kt thc iu ch khi bo qun nhit t 20 oC n 24oC kmtheo lc lin tc.

iu 32. Huyt tng v huyt tng ng lnh

1. Huyt tng l phn dch lng khng cha cc t bo mu, c iu ch

t n v mu ton phn hoc ly trc tip t ngi hin huyt tng bng gntch. Huyt tng c th c s dng ngay sau iu ch hoc c ng lnh(gi l huyt tng ng lnh) theo quy nh ti Khon 3 iu 18 Thng t ny.

2. Tiu chun v kim tra cht lng: thc hin kim tra cht lng (vi slng mu ly ngu nhin theo t l 0,1% n 1% tng s cc n v c iuch v khng thp hn 05 n v mi thng) v cc tiu chun sau:

a) Nng protein khng thp hn 50 g/l;

b) Th tch huyt tng chnh lch khng qu 10% th tch ghi trn nhn.

3. iu kin bo qun v hn s dng

a) Bo qun nhit t 2oC n 6oC: hn s dng ca huyt tng l khng qu 14 ngy k t thi im iu ch trong h thng kn v khng qu 24gi k t thi im iu ch trong h thng h;

b) Bo qun nhit t m 18oC (-18oC) n m 25oC (-25oC): hn sdng ca huyt tng khng qu 12 thng k t thi im ly mu hoc gn tchhuyt tng;


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c) Bo qun nhit t m 25oC (-25oC) tr xung: hn s dng ca huyt

tng khng qu 24 thng k t thi im ly mu hoc gn tch huyt tng.d) Khng c ng lnh li huyt tng lm tan ng.

iu 33. Huyt tng ti v huyt tng ti ng lnh

1. Huyt tng til huyt tng c nng cc yu t ng mu khngbn vng duy tr nng sinh l, c iu ch t mu ton phn hoc ly trctip t ngi hin mu bng phng php gn tch.

2. Huyt tng ti ng lnh l huyt tng c quy nh ti Khon 1iu ny v c lm ng lnh huyt tng trong khong thi gian ti a l 18gi k t khi ly mu hoc gn tch huyt tng. Vic lm ng lnh huyt tng

phi thc hin theo quy nh ti Khon 3 iu 18 Thng t ny.

3. Tiu chun v kim tra cht lng i vi huyt tng ti v huyttng ti ng lnh: thc hin kim tra cht lng (vi s lng mu ly ngunhin theo t l t 0,1% n 1% tng s n v c iu ch v khng thp hn05 n v mi thng) v cc tiu chun sau:

a) Th tch huyt tng chnh lch khng qu 15% th tch ghi trn nhn;

b) Nng yu t VIII khng thp hn 0,7 IU (n v quc t)/ml. C tnht 75% s mu c kim tra phi t tiu chun ny;

c) S lng t bo tn d: hng cu t hn 6,0109/l, bch cu t hn0,1!109/l, tiu cu t hn 50109/l;

d) Nng protein ton phn khng thp hn 50g/l;

) Khng c mu sc bt thng, khng c vn, cc ng.


a) Bo qun nhit t m 18o

C (-18o

C) n m 25o

C (-25o

C): hn sdng ca huyt tng khng qu 12 thng k t thi im ly mu hoc gn tchhuyt tng;

b) Bo qun nhit t m 25oC (-25oC) tr xung: hn s dng ca huyt

tng khng qu 24 thng k t thi im ly mu hoc gn tch huyt tng;

c) i vi ch phm huyt tng ti v huyt tng ti ng lnh lmtan ng:

- Bo qun nhit t 2oC n 6oC: phi s dng ngay trong vng 06 gi


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tnh t thi im bt u lm tan ng; phi thay nhn ph hp (huyt tng) nu

bo qun trn 06 gi;- Khng c ng lnh li huyt tng ti ng lnh lm tan ng.

iu 34. Ta lnh

1. Ta lnh l ch phm tch t phn ta hnh thnh trong qu trnh tan nghuyt tng ti ng lnh nhit t 10oC tr xung.Ta lnh c th tip tcc tinh ch v bt hot virtbng ha cht hoc nhit .

2. Tiu chun v kim tra cht lng: thc hin kim tra cht lng (vi slng mu ly ngu nhin t 0,1% n 1% tng s cc n v c iu ch v

khng thp hn 05 n v mi thng) v cc tiu chun sau:

a) Th tch t 10ml n 25ml cho mi n v ta lnh iu ch t mt nv mu ton phn c th tch ln hn hoc bng 250 ml. Th tch t 80 ml n 120ml cho mi pool ta lnh t 2.000 ml mu ton phn. Th tch ta lnh thc ochnh lch khng qu 15% th tch ghi trn nhn.

b) Nng yu t VIII khng t hn 30 IU cho mi n v ta lnh iu cht mt n v mu ton phn c th tch ln hn hoc bng 250 ml v t nht75%s mu c kim tra t tiu chun ny;

c) Lng fibrinogen khngthp hn 75mg cho mi n vta lnh cha bthot vi rt iu ch t mtn v mu ton phnc th tch ln hn hoc bng 250ml v t nht 75% s mu c kim tra t tiu chun ny;

d) Khng c mu sc bt thng, khng c vn, cc ng.


a) Bo qun nhit t m 18oC (-18oC) tr xung: hn s dng ca talnh khng qu 12 thng;

b) Ta lnh lm tan ng:- Khi bo qun nhit t 2oC n 6oC phi s dng ngay ta lnh hoc

trong vng 06 gi tnh t thi im bt u lm tan ng;

- Khng c ng lnh sau khi lm tan ng.

iu 35. Khi bch cu ht trung tnh

1. Khi bch ht trung tnh c gn tch trc tip t ngi hin mu hoc iu ch t cc n v mu ton phn c bo qun nhit t 20 oC n 24oCkhng qu 24 gi k t thi imly mu.


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2. Tiu chun v kim tra cht lng: thc hin kim tra cht lng (vi s

lng mu ly ngu nhin theo t l 10% tng s n v c iu ch) v cc tiuchun sau:

a) Th tch n v ch phm: t 250 ml n 300 ml;

b) C 10!109bch cu ht trung tnhtrong mi n v ch phm vt nht75% s n v ch phm c kim tra t tiu chun ny.

3. iu kin bo qun v hn s dng: bo qun nhit t 20oC n24oC, khng lc, trong vng 06 gi k t thi im iu ch v trong vng 24 gik t thi im ly mu.

iu 36. Cc ch phm mu truyn cho thai nhi1. Khi hng cu truyn cho thai nhi l khi hng cu lc bch cu theo quy

nh ti iu 27 Thng t ny v phi p ng thm cc yu cu sau:

a) c bo qun nhit t 2oC n 6oC trong vng 05 ngy k t thiim ly mu;

b) Hematocrit t 0,70 n 0,85;

c) C th c chiu xtheo quy nh ti Khon 4, iu 18 Thng t ny.

2. Khi tiu cu truyncho thai nhi l khi tiucu lc bch cu theo quynh ti iu 31 Thng t ny, ngoi ra c th c chiu x theo quy nh tiKhon 4, iu 18 Thng t nykhi c ch nh ca bc s iu trlm sng.

iu 37. Mu s dng trong truyn thay mu cho tr s sinh

1. Mu ton phn s dng truyn thay mu cho tr s sinh: phi p ngcc iu kin theo quy nh ti iu 22 Thng t ny v c bo qun trong vng05 ngy k t thi im ly mu. Mu ton phn s dng truyn cho tr s sinhc th lc bch cu, chiu x theo ch nh ca bc s iu tr lm sng.

2. Mu ton phn khi phc s dng truyn thay mu cho tr s sinh: lkhi hng cu c iu ch theo quy nh ti mt trong cc iu 23, 24, 25, 26,27 v 28 Thng t ny v c b sung huyt tng ti hoc huyt tng ting lnh quy nh ti iu 33 Thng t ny khi phc c tnh nh mu ton

phn, ngoi ra phi p ng cc yu cu sau:

a) Khi hng cu c bo qun trong vng 05 ngy tnh t ngy ly muhoc ngy lm tan ng hng cu ng lnh;

b) c loi b dung dch bo qun sau khi ly tm;


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c) c b sung huyt tng ti ng lnh nhm AB hoc nhm khc ph

hp min dch vi nhm ca n v khi hng cu v nhm mu ca tr s sinh;d) Ch phm bo qun nhit t 2oC n 6oC v s dng trong vng 04

gi k t thi im c khi phc;

) Kim tra cht lng tt c cc n v mu ton phn khi phc theo quynh ti Khon 3 iu 22 Thng t ny v hematocrit t t 0,40 n 0,50;

e) Mu ton phn khi phc s dng truyn thay mu cho tr s sinh,c lc bch cu, chiu x trong trng hp cn thit theo ch nh ca bc siu tr lm sng.

Chng VQUN L, S DNG MU V CH PHM MU C S IU TR

iu 38. Nguyn tc cp pht, s dng, thu hi mu v ch phm mu

1. Ch c cp pht n v mu v ch phm mu cho ngi bnh khi:khngpht hin thy nguy c nhim cc tc nhn ly truyn bnh qua ng mu;

c y kt qu xt nghim nh nhm mu h ABO, Rh(D); n v mu, chphm mu t tiu chun quy nh tng ng v khng vt quthi hn s dngtheo quy nh i vi tng loi; khng c cc du hiu bt thng khi kim trahnh thc bn ngoi; bo m ha hp min dch gia n v mu, ch phm muv ngi c truyn mu.

2. Thu hi, cch ly cc n v mu, ch phm mutrong:

a) Cc trng hp quy nh ti Khon 2, Khon 3iu 17Thng t ny;

b) Cc trng hp quy nh ti Khon 2 iu 41 Thng t ny.

c) Cc n v mu ton phn v cc ch phm huyt tng, khi tiu cu,khi bch cu iu ch t nv mu, thnh phn mu khi xt nghim khng th

bt thng theo quy nh ti im c Khon 4 iu 14 Thng t ny c kt qudng tnh hoc nghi ng dng tnh.

3. Ch nh s dng truyn mu hp l trn c s tnh trng bnh l catng ngi bnh.

4. B phn pht mu ca c s khm bnh, cha bnh thc hin xt nghimha hp min dch truyn mu v trc tip cp pht mu cho cc khoa iu tr lm


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sng thuc c s khm bnh, cha bnh thc hin truyn mu, ch phm mu

cho ngi bnh.iu 39. Giao, nhn mu v ch phm mu

Vic giao, nhn mu v ch phm mu gia c s cung cp mu vi c skhm bnh, cha bnh hoc gia cc c s khm bnh, cha bnh vi nhau chc thc hin khi p ng cc iu kin sau:

1. C s y t c c quan c thm quyn cho php thc hin vic cungcp mu cho c s khm bnh, cha bnh khc;

2. C hp ng hp php cung cp mu gia c s cung cp v c s nhn

mu, ch phm mu;3. C phiu d tr, cung cp mu v ch phm mu theo quy nh ti Ph

lc 8 ban hnh km Thng t ny;

4. Trng hp khng c hp ng cung cp mu:phiu d tr phi c xcnhn ca i din lnh o hoc ngi c y quyn ca c s khm bnh, cha

bnh ;

5. C cc nhn vin y t thc hin vic giao v nhnmu;

6. C phng tin bo qun, vn chuyn mu v ch phm mu ph hp;7. H s giao nhn mu phi c lu gi v kim sot theo quy nh ti

iu 61 Thng t ny.

iu 40. Nhp kho, i chiu, bo qun mu ti n v pht mu cac s khm bnh, cha bnh

1. Mu v ch phm mu trc khi nhp kho phi c i chiu, kim tra:

a) Hnh thc bn ngoi v bao gi theo quy nh ti iu 41 Thng t ny;

b) Thng tin trn nhn theo quy nh ti iu 21 Thng t ny;

c) iu kin bo qun, vn chuyn mu ph hp vi tng loi mu, chphm mu theo cc quy nh ti cc iu 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32,33, 34 v 35 Thng t ny.

d)Ngi kim tra, i chiu phi bo co ngi ph trch n v pht mu vccbt thng pht hin c khi i chiu xem xt, quyt nhcch thc x l.

2. Bo qun ring r cc ti mu, ch phm mu theo nhm mu A, B, O, AB,Rh(D) m trong cc ngn (khoang) khc nhau ca thit b lnh hoc trong cc thit

b lnh ring bit.


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iu 41. Kim tra hnh thc bn ngoi ti mu, ch phm mu

1. Phi kim tra hnh thc bn ngoi ti mu v ch phm mu trong cctrng hp sau:

a) Giao nhn gia cc b phn trong c s truyn mu;

b) Giao nhn gia c s cung cp mu v n v pht mu ca c s khmbnh, cha bnhhoc gia cc n v pht mu ca cc c s khm bnh, chabnh vi nhauhoc giao nhn gia c s cung cp muvi nhau.

c) Giao nhn gia n v pht mu v n v iu tr ca cng c s khmbnh, cha bnh.

2. Khng s dng cc n v mu v ch phm mu, khi pht hin thy ccdu hiu sau:

a) Thng, h, nt, v ti ng, ng dy, v tr cm dy truyn;

b) Hin tng khng phn lp hoc phn lp bt thng gia cc thnhphn mu khi lng hoc ly tm;

c) C mu sc bt thng:

- Mu hng hoc phn trn mt phn cch huyt tng v hng cu

hoc ton b huyt tng;-Huyt tng c mu sc bt thng;

- Phn hng cu i mu tm hoc en sm hoc mu sc bt thng khc.

d) C cc ng, vn, ta;

) C nivng trn b mt.

c c , c p

1. Bc s iu tr cn nh gi tnh trng bnh l v pht hin sm nhu cu

cntruyn mu ngi bnh.2. Bc s iu tr phi ch nh thc hin cc xt nghim cho ngi bnh c

d kin cn truyn mu:

a) nh nhm mu ABO, Rh(D);

b) Sng lc khng th bt thng cho nhng ngi bnh:- C tin s truyn mu;- Ph n c tin s cha, , xy thai nhiu ln;

-Nu trong qu trnh iu tr, ngi bnh cntruyn mu nhiu ln, nhiu

ngyphilm li xt nghim ny nh k khng qu 7 ngymt ln.


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c) Trng hp xt nghim sng lc khng th bt thng cho kt qu

dng tnh, cn ch nh lm xt nghim nh danh khng th bt thng;d) Trng hp ngi bnh c khng th bt thng c nh danh, cn

ch nh la chn n v mu ph hp, khng c cc khng nguyn tng ng vicc khng th c trong huyt thanh ca ngi bnh;

) Trng hp khng th nh danh khng th bt thng hoc khng tmc n v mu ph hp, bc s iu tr phi phi hp vi n v cp pht mu xem xt, quyt nh p dng bin php iu tr thch hp.

3. Ch nh truyn mu sau khi cn nhc li ch v nguy c ca truyn

mu i vi tng ngi bnhkhi khng c liu php iu tr thay th khc, hoccc liu php iu tr thay th khng c hiu qu.

4. Bc s iu tr hoc iu dng vin phi thng bo cho ngi bnhhoc ngi nh v li ch v nguy c c th xy ra do truyn mu. Trong trnghp khn cp cn truyn mu ngay nhng khng th thng bo c do ngi

bnh b hn m, khng c ngi nh th bc sphi ghi r vi s xc nhn ca mtnhn vin y t vo h s bnh n.

Ngi bnh hoc ngi nh ngi bnh phi xc nhn v k vo bnh n nut chi vic truyn mu, ch phm mu.

5. iu dng vin lp phiu d tr cung cp mu theo mu quy nh tiPh lc 9 ban hnh km theo Thng t ny v ly mu mu tnh mch ca ngi

bnh c ch nh truyn mu theo cc yu cu sau:

a) Khi ly mu mu phi kim tra ch nh truyn mu, tn, tui, m sngi bnh, khoa, s ging iu tr i chiu vi h s bnh n;

b) Mu mu ca ngi bnh phi ly vo 2 ng nghim vi th tch t 1 mln 2 ml mu c chng ng v 4 ml n 5ml mu khng chng ng;

c) Ghi thng tin trn nhn ng nghim:- H v tn hoc m s ca ngi bnh;

-Nm sinh ca ngi bnh;

- S ging, khoa phng iu tr.

d) Chuyn phiu d tr v cc mu mu cho n v pht mu;

iu 43. Xt nghim bo m ha hp min dch truyn mu

Khi nhn c phiu d tr v mu mungi bnh, nhn vin n v phtmu phi thc hin cc cng vic sau:


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1. Kim tra, i chiu thng tin mu mu vi phiu d tr. Trng hpthng tin khng trng khp, th mu mu khng c dng nh nhm muv xt nghim ha hp.

2. nh nhm mu h ABO mu mu ngi bnh v n v mu:

a) nh nhm mu h ABO theo k thut trong ng nghim hoc cc kthut khc c nhy cao hn;

b) Thc hin nh nhm mu ng thi bng hai phng php huyt thanhmu v hng cu mu cho mu mu ngi bnh, n v mu ton phn v khi

bch cu ht. nh nhm mu bng phng php huyt thanh mu cho cc chphm hng cu. nh nhm mu bng phng php hng cu mu cho cc ch

phm huyt tng, ta lnh v tiu cu;c) Vic nh nhm mu ngi bnh c thc hin hai ln trn cng mu

mu hoc hai mu mu ca cng mt ngi bnh. Trng hp cc kt qu ca haiphng php nh nhm mu h ABO trong cng mt ln hocca cc ln nhnhm mu khng ph hp vi nhau, phi thc hin cc xt nghim b sung khng nh kt qu nh nhmmu;

d) nh nhm mu ABO ca tr s sinh v thai nhi: Ch thc hin nhnhm mu bng phng php huyt thanh mu; khng nh nhm mu bng

phng php hng cu mu. Trong trng hp kt qu nh nhm mu khng rrng, c th s dng cc xt nghim b sung khc khng nh. Nu khng thxc nh c nhm mu, cn chn laha hp min dch theo quy nh tiKhon1 iu 45 Thng t ny.

3. nh nhm muh Rh(D) mu mu ngi bnh:

a) Khi c ch nh truyn n v mu ton phn, khi hng cu, khi tiucu v khi bch cu;

b) Thc hin nh nhm mu h Rh(D) bng k thut trong ng nghimhoc cc k thut khc c nhy cao hn.

4. i chiu kt qu xt nghim sng lc v nh danh khng th b tthng thc hin trc theo quy nh ti cc im b,c, d v Khon 2 iu42 Thng t ny.

5. Thc hin xt nghim ha hp min dch truyn mu:

Thc hin xt nghim ho hp min dch trong ng nghim hoc bng cc k thut c nhy cao hn trong nhng trng hp sau:

a) Truyn mu ton phn, khi hng cu cn nhiu huyt tng, khi bch cu:

-Xt nghim ho hp min dch mi trng nc mui sinh l, nhitphng xt nghim 20oC n 24oC gm:


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+ ng 1: Gm hng cu ca n v mu, ch phm mu vi huyt thanh

ngi nhn;+ ng 2: Gm huyt tng ca n v mu, ch phm mu vi hng cu

ngi nhn.

-Xt nghim ho hp min dch nhit 37oC v c s dng huyt thanhkhng globulin (nghim php Coombs gin tip): Thc hin xt nghim ho hpgia hng cu ca n v mu, khi hng cu, khi bch cu vi huyt thanh cangi nhn bng phng php ng nghim nhit 37oC v c s dng huytthanh khng globulin hoc k thut c nhy cao hn.

b) Truyn cc loi khi hng cu cn t hoc khng cn huyt tng:-Xt nghim ho hp min dch mi trng nc mui sinh l, nhit

phng t 20oC n 24oC gia hng cu ca n v mu vi huyt thanh nginhn(ng 1);

-Xt nghim ho hp min dch nhit37oC v c sdnghuyt thanhkhng globulin (nghim php Coombs gin tip): thc hin xt nghim ho hpgia hng cu ca n v mu, khi hng cu, khi bch cu vi huyt thanh cangi nhn bng phng php ng nghim nhit 37oC v c s dng huyt

thanh khng globulin hoc k thut c nhy cao hn.c) Truyn ch phm tiu cu, huyt tng: thc hin xt nghim ho hp

gia huyt tng ca n v ch phm mu vi hng cu ngi nhn trong ngnghim (ng 2) mi trng nc mui sinh l, nhit phng t 20oC n 24oChoc k thut c nhy cao hn;

d) Kt qu xt nghim ha hp c coi l m tnh khi khng c hintng ngng kt, tan mu. Ch cp pht n v mu khi kt qu xt nghim hahp l m tnh, tr trng hp truyn ta lnh theo quy nh ti Khon 3 iu 44Thng t ny;

) Khi kt qu cc xt nghim ho hp c hin tng ngng kt hoc tanmu cn kim tra, i chiu h s, cc thng tin c lin quan vphi hp vi bcs iu tr ch nh xt nghim thc hin cc yu cu quy nh ti cc im b,c,d v Khon 2 iu 42 Thng t ny.

6. Sau khi hon thnh cc cng vic theo quy nh ti cc khon 2, 3,4 v5 iu ny, nhn vin n v pht mu lp h s cp pht mu nh sau:

a) Phiu truyn mu theo mu quy nh ti Ph lc 10 ban hnh km theo

Thng t ny, c gi cho n v iu tr s dng mu;


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b) H s ghi kt qu nh nhm mu, xt nghim ho hp min dch v

c lu ti n v pht mu.iu 44. La chn n v mu ho hp min dch

1.

Truyn n v mu ton phn v khi hng cu ho hp nhm mu hABO vi ngi nhn, theo yu cu sau:

Nhm mu ngi bnhnhn mu

Nhm mu n v mu truyn

Khi hng cu Mu ton phn

O O O

A A hoc O A

B B hoc O BAB AB hoc A hoc B hoc O AB

2. Truyn cc n v ch phm huyt tng ha hp nhm mu h ABOvi ngi bnh nhn mu theo cc yu cu sau:

Nhm mu ngi bnh nhn mu Nhm mu n v huyt tng truyn

O O hoc B hoc A hoc AB

A A hoc AB

B B hoc AB

AB AB

3. C th truyn ta lnh khng ho hp nhm h ABO cho ngi bnhnhn mu vi liu lng truyn khng vt qu 10 ml/kg cn nng c th trongkhong thi gian 12 gi.

4. Chn la cc ch phm tiu cu v bch cu ht theo yu cu sau:

Nhm mu ngibnh nhn mu

Nhm mu ca n v mu, ch phm mu truynn v mu, ch phmmu cn huyt tng

nguyn thu

n v mu, ch phmmu loi b huyt tng

nguyn thu

O O O

A A A hoc O

B B B hoc O

AB AB AB hoc A hoc B hoc O


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5. Chn la cc n v mu ton phn, khi hng cu, tiu cu, bch cuht theo nhm Rh(D) theo yu cu sau:

Nhm mu ngi bnh nhn mu Nhm mu ca n v mu truyn

D(-) D(-)

D(+) D(+) hoc D(-)

iu 45. Bo m ha hp min dch trong mt s trng hp cp cu

1. Trong trng hp cp cu, khng kp lm y xt nghim theo quynh ti Khon 2 iu 42 v iu 43 Thng t ny hoc khng xc nh c

nhm mu ngi bnh hoc khng la chn c n v mu, ch phm mu phhp, nu c s ng bng vn bn ca bc s iu tr c th cp pht nh sau:

a) Truyn thay nhm mu cho ngi bnh c ch nh truyn mu ton phn, khihng cutheo quy nh ti Khon 1 iu 44 Thng t ny.

b) Truyn khi hng cu ha hp h ABO v Rh(D) m cho ngi bnhnhm mu Rh(D) m hoc khng xc nhnhm Rh(D);

c) Truyn thay nhm mu cho ngi bnh c ch nh truyn huyt tngtheoquy nh ti Khon 2 iu 44 Thng t ny.

2. Ch truyn mu nhm Rh(D) dng cho ngi nhn mang nhm Rh(D)m trong trng hp e da n tnh mng ngi bnh v c cc iu kin sau:

a)Ngi bnh l nam gii.

b) Trong trng hpngi bnh l ph ntrong tui sinh : cn nhcli ch iu tr hin ti v nguy c tai bin cho thai nhi nu ngi bnh mang thaitrong tng lai;

c) Xt nghim ha hp min dchs dng huyt thanh chng globulin nhit

37o

C cho kt qu m tnh;d) C s ng bng vn bn trong kt qu hi chn gia ngi ph trch

hoc ngi c y quyn ca n v pht mu, bc s iu tr v c s ng ca ngi bnh hoc ngi nhca ngi bnh.

iu 46. Lm tan ng, m ti mu, ch phm mu

1. Vic lm tan ngti ch phm mu phi bo m cc iu kin sau:

a) Lm tan ng ch phm mu theo quy nh ti im c Khon 3 iu 18Thng t ny;


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b) Thi gian t khi kt thc vic lm tan ngn khi kt thc vic truyn

mu cho ngi bnh khng qu 06 gi;c)Sau khi lm tan ng, phi kim tra tnh trng ti mu, ch phm mu

quy nh ti Khon 2 iu 41 Thng t ny. Nu pht hin ti mu khng bo mcht lng th phi hy ti mu .

2. m on dy truyn n v ch phm mu khi cn truyn nhanh vkhi lng ln (trn 50 ml/kg/gi ngi ln v trn 15 ml/kg/gi tr em). Nhit m khng vt qu 37oC.

iu 47. Giao nhn mu, ch phm mu gia nv pht mu v n

v iu tr1. Khi giao nhn mu, ch phm mu,nhn vin n v iu tr lnh mu v

nhn vin ca n v pht mu phi thc hin i chiu thng tin trn phiu d trmu, n v muvphiu truyn mu.

2. C phng tin bo qun, vn chuyn mu, ch phm mu ph hp.

8 L ca g b

Sau khi cp pht, mu mu ca ngi bnh nhn mu v mu n v mu cp pht phi c lu gi t nht 05 ngy nhit t 2 oC n 6oC ti n v

pht mu.

iu 49. Qun l ti mu n v iu tr

1. Ti mu chuyn v n v iu tr phi truyn cho ngi bnh trongvng 06 gi k t thi im giao nhn gia n v pht mu v n v iu tr.

2. Trng hp cha tin hnh truynmu, cc ti mu hoc ch phm muphi c bo qun ph hp theo quy nh ti cc iu 22, 23, 24, 25, 26,27, 28,29, 30, 31, 32, 33, 34 v 35 Thng t ny.

iu 50. Thc hin v theo di truyn mu ti n v iu tr1. Bc s iu tr v iu dng vin phi thc hinkim tra, i chiu,

nh nhm mu, theo di truyn mu,pht hin, x tr kp thi cc bt thng, taibinkhng mong mun xy ra trong v sau truyn mu.

2. Thc hin kim tra, i chiu cc ni dung sau:

a) i chiu thng tin ca ngi bnh, n v mu v phiu truyn mu;

b) Kim tra hn s dng vhnh thc bn ngoi ti mu theo quy nh tiiu 41 Thng t ny.


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3. Thc hin nh nhm mu h ABO ca ngi bnh, ca ti mu ngay ti

ging bnh v i chiu vi thng tin trnphiutruyn mua) Khi truyn mu ton phn, khi hng cu, khi bch cu: s dng huyt

thanh mu nh nhm mu ABO ca mu mu ngi bnh c ly ngay trc khitruyn mu v ca mu mu ly t n v mu sp truyn.

b) Khi truyn tiu cu, huyt tng:

- S dng huyt thanh mu nh nhm mu ABO mu mu ca ngi bnh;

- Trn 02 git ch phm mu vi 01 git mu ngi bnh v kim trangng kt. Khng thc hin truyn mu khi c ngng kt, tr trng hp truynta lnh theo quy nh ti Khon 3 iu 44 Thng t ny.

c) Phi hp vi n v pht muiu tra lm r mis khc bit (nu c)gia h s bnh n, phiu truyn mu, nhn n v mu v kt qu nh nhm.

4. Thc hin vic truyn mu, theo di din bin, pht hin, x tr cc btthng v tnh trng sc khe ca ngi bnh:

a) Kim tra, theo di cc ch s mch, nhit , huyt p, trng thi tinhthn ca ngi bnh vo cc thi im trc v trong qu trnh truyn mu, c

bit lu theo di trong 15 pht u truyn mu pht hin v x tr kp thi taibinlin quan n truyn mu;

b) Phi s dng b dy truyn mu c bu lc truyn cho ngi bnh;

c) Ghi h s y cc ch s mch, nhit, huyt p, trng thi tinh thn,din bin lm sng ca ngi bnh, cc x tr (nu c) vo phiu truyn mu theoquy nh ti Ph lc 10 ban hnh km theo Thng t ny;

d) Cn c tnh trng ca ngi bnh v din bin trong qu trnh truynmu, bc s iu tr ch nh vic theo di sau khi kt thc truyn mu.

5.Khng c b sung bt c cht g (bao gm c cc loi thuc) vo timu, tr trng hp c ch nh ho long khi hng cu th ch c s dng dungdch mui ng trng (NaCl 0,9%) loi truyn tnh mch.

6. Khi xy ra cc tai binlin quan n truyn mu,c s iu tr phi thchin ngay cc vic sau:

a) Ty theo mc nghim trng ca tai bin m phi gim tc hocngng truyn mu. Trng hp ngng truyn mu, phi duy tr ng truyn tnhmch bng cch s dng dung dch mui ng trng;

b) X tr cp cu ngi bnh;


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c) Khng c tip tc truyn n v mu, ch phm mu c lin quan n

tai binsau khi ngng truyn qu 4 gi.iu 51. Vic tr, nhn li v s dng n v mu c tr li

1. Khi khng s dng n v mu cp pht, csiu tr (khoa, phng)phi tr li ngay cho cspht mu.

2. C spht mu ch s dng n v mu tr li truyn cho ngibnh khc khi c y nhng iu kin sau:

a) Cn hn s dng;

b) Khng pht hin c cc du hiu bt thng c quy nh ti iu41 Thng t ny;

c) n v mu sau khi lnh, c bo qun, vn chuyn iu kin ngquy nh v c xc nhn bng vn bn ca ngi ph trch khoa, phng iu tr.

iu 52. Xc nh nguyn nhn gy tai binlin quan n truyn mu

1. Khi xut hin cc tai bin xy ra trong v sau truynmu, xc nhnguyn nhn, c s iu tr phi thc hin ngay mt s vic sau:

a) i chiu thng tin h s bnh n ca ngi bnh, nhn n vmu

truyn v phiu truyn mu. Kt qu i chiu phi ghi h s bnh n.b) Thu thp li mu mu ngi bnh ly trc khi truyn mu, ng thi

ly mu mu, mu nc tiu ca ngi bnh. Trng hp tai bin nng e da ntnh mng ngi bnh, phi tin hnh nh nhm mu h ABO ngay ti ging

bnh do nhn vin ca c spht mu thuc c s khm bnh, cha bnh thchin. Kt qu nh nhm mu phi ghi bnh n vixc nhn ca bc s iu tr,lnh o c siu tr v ngi thc hin k thut nhnhm mu;

c) Thng bo tai binc lin quan n truyn mu cho c spht mu v phngk hoch tng hp theo quy nh ti Ph lc 11 ban hnh km theo Thng t ny;

d) Chuyn cc n v mu, ch phm mu c lin quan v c spht mu thc hin tip cc cng vic theo quy nh ti Khon 2 iu ny;

) Phng k hoch tng hp lp bo co Hi ng truyn mu v c s cung cp n v mu, ch phm mu theo mu quy nh ti Ph lc 11 ban hnhkm theo Thng t ny.

2. C spht muphi kim tra, i chiu li h s lin quan, thc hin ccxt nghim nhm xc nh nguyn nhn tai binlin quan n truyn mu v tr likt qu xt nghim cho c siu tr, phng k hochtng hp theo mu quy nh

ti Ph lc 12 ban hnh km theoThng t ny.


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3. C spht mu phi hp vi c s cung cp n v mu, ch phm

mu c lin quan xc nh nguyn nhn.

Chng VITRUYN MU T THN

iu 53. Nguyn tc thc hin truyn mu t thn

1. Phi c cc quy trnh truyn mu t thn ph hp vi cc quy nh hinhnh v iu kin ca c s khm bnh, cha bnh. Cc quy trnh chn la, xtnghim, ly, iu ch, bo qun v truyn mu t thn phi c lnh o ca cs khm bnh, cha bnhph duyt.

2. Ch truyn mu t thn theo k hoch i vi nhng trng hp trcphu thut c tin lng v nguy c mt mu n mc phi truyn mu v bc siu tr c trch nhim cn nhc, nh gi tnh trng sc kho ngi bnh cho phpthc hin ly mu an ton.

3. Vic ly mu theo phng php truyn mu t thn theo k hoch vtruyn mu t thn pha long mu ng tch ch c thc hin khi c s ng

bng vn bn ca ngi bnh hoc ngi i din hp php ca ngi bnh.4. Ngoi vic tun th cc quy nh v nhn ti mu theo quy nh ti iu

21 Thng t ny, nhn ca ti mu t thn phi c ghi thm dng ch: Chdng cho truyn mu t thn.

5. Cc ti mu t thn phi c bo qun ring bit vi mu ly t ngihin mu.

6. Bo m truyn mu, ch phm mu cho ng ngi bnh c lymu. Mu thu nhn vi mc ch truyn mu t thn khng c s dng cho

ngi bnh khc.iu 54. Truyn mu t thn theo k hoch

1. Tiu chun la chn ngi bnh

a) Tui t 16 n 60;

b) Trng lng c th t 50 kg trln;

c) Lm sng: theo quy nh ti im d Khon 2 iu 4 Thng t ny;

d) Nng Hemoglobin phi t t nht l 120g/l v Hematocrit phi t t

nht 0,33;


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2. Cc xt nghim phi thc hin trc khi ly mu, gm:

a) nh nhm mu h ABO;b) Xt nghim pht hin cc tc nhn ly truyn bnh qua ng mu, ti

thiu gm: HBsAg, khng th khng HIV-1 v HIV-2, khng th khng HCV,giang mai.

3. Th tch mu ly mi ln khng qu 7 ml/kg cn nng; mi ln ly mucch nhau ti thiu 03 ngy v ln ly mu cui cng trc thi im phu thut tnht 72 gi.

4. Bc s iu tr xem xt ch nh s dng cht kch thch to hng cuErythropoietin.

5. Vic iu ch, bo qun n v mu, ch phm mu ph hp theo quynh ti cc iu 22, 23, 24, 25, 26,27, 28, 29, 30, 31, 32, 33, 34 v 35 Thng tny.

6. Thc hin xt nghim ho hp min dch trc khi truyn mu, thc hintruyn mu v xc nh nguyn nhn gy tai binlin quan n truyn mu t thn

phi thc hin theo cc quy nh ti cc iu 40,41, 43, 46, 47, 48, 49, 50, 51 v 52

Thng t ny.iu 55. Truyn mu t thn pha long mu ng tch

1. Tiu chun la chn ngi bnh

a) Tui t 16 tui n 60 tui;

b) Trng lng c th t 50 kg tr ln;

c) Lm sng: theo quy nh ti imd Khon 2 iu 4 Thng t ny;

d) Nng Hemoglobin phi t t nht l 120g/l v Hematocrit phi t t

nht l 0,33;) Phu thut c s dng k thut tin m hoc gy m ton thn;

e) Khng p dng ch nh truyn mu t thn pha long ng tch trongtrng hp ngi bnh c dung np km i vi tnh trng gim cung cp oxy.

2. Cc xt nghim phi thc hin trc khi ly mu: thc hin theo quynh ti Khon 2 iu 54 Thng t ny.

3. Yu cu i vi vic thc hin pha long mu ng tch v truyn li chongi bnh:

a) Th tch mu ly trc phu thut khng qu 7 ml/kg cn nng;


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b) Hematocrit ca ngi bnh khng c thp hn 0,25 sau khi ly mu;

c) Phi duy tr cn bng th tch mu ly ra v th tch dch truyn vo cth bng cc loi dung dch ng trng theo t l s lng dch truyn vo c thgp 3 ln s lng mu c ly ra khi c th hoc bng dung dch cao phn ttheo t l 1:1.

iu 56. Truyn mu hon hi

1. Ch thc hin truyn mu hon hi khi khng c mu lu tr cpcu v khng c phng thc iu tr khc thay th truyn mu cho ngi bnh.

2. Mu hon hi c ly trong qu trnh phu thut hoc t ng dn lu.V d: trong trng hp v lch, dn lu t trung tht sau phu thut m tim.

3. Mu thu c truyn hon hi phi c x l theo quy trnh ph hp trnh nguy c nhim khun, tan mu v loi b c cc ng mu.

4. Mu hon hi phi c truyn trong vng 04 gi, k t thi im thunhnmu hon hi.

5. H s truyn mu hon hi phi c lu trong bnh n ca ngi bnh.

6. Khng thc hin truyn mu hon hi trong cc trng hp sau:

a) V tng rng;

b) Mu chy ra qu 06 gi;

c) Mu c nguy c nhim khun;

d) C du hiu tan mu.

Chng VIIGIM ST NGUY C TRONG TRUYN MU

iu 57. Ni dung gim st nguy c trong truyn mu

Gim st nguy c trong truyn mu l hot ng nhm phng, pht hin,cnh bo, lu gi, phn tch, bo co cc nguy c gy mt an ton truyn mu, baogm:

1. Thng tin v ngi hin mu.

2. Thng tin v quy trnh, nhn lc, sinh phm, trang thit b, dng c, vt


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t tiu hao thc hin cc hot ng tip nhn, sng lc, iu ch, bo qun, vn

chuyn, cp pht, ch nh,s dng mu trong lm sng.3. Thng tin v kt qu v cc bt thng trong hot ng truyn mu.

4. Cc thng tin v tai binxy ra ngi bnh ctruyn mu.

5. Cc thng tin khc v cc nguy c, bt thng cho cng ng dn c, x

hi c lin quan n hot ng truyn mu.

iu 58. Qun l, gim st, bo co nguy c trong truyn mu

1. Mi bt thng xy ra trong hot ng truyn mu phi c pht hin,

kim tra, x l, tng hp v bo co theo nh k 6 thng/ln.

2. Khi xy ra cc bt thng c nguy c nh hng n an ton cho ngi

bnh hoc vt qu kh nng x l ca c s khm bnh, cha bnh:

a) Khoa, phng pht hin phi bo co lnh o c s khm bnh, cha

bnhtrong thi gian 02 gi, k t khi pht hin;

b) Trong thi gian 24 gi, k t khi nhn c bo co, lnh o c s

khm bnh, cha bnhphi bo co cho c quan qun l cp trn v c s truyn

mu c lin quan.

3. Khuyn khch bo co cc nguy c, bt thng c lin quan n ngi

hin mu, ngi bnh nhn mu, nhn vin y t thc hin cng vic v nhng

ngikhc c lin quan n hot ng truyn mu:

a) Cc bo co thc hin theo quy nh ti Ph lc 13 ban hnh km Thng t ny;

b) Cc bo co ny c gi n Hi ng truyn mu ca c s khm

bnh, cha bnh v Vin Huyt hc - Truyn mu Trung ng.

4. nh k hng nm, cc c s c hot ng truyn mu phi thc hin

vic tng hp, phn tch, xut cc gii php nhm khc phc, hn ch cc bt

thng trong truyn mu vbo co theo quy nh ti iu 62 Thng t ny.

5. Cn c bo co theo quy nh ti Khon 3 v Khon 4 iu ny, Vin

Huyt hc Truyn mu Trung ng thc hin vic tng hp, phn tch, xut

cc gii php, tham mu cho B Y t v cc bin php nhm khc phc, hn ch,

phng nga cc nguy c trong truyn mu.


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Chng VIII

HING TRUYN MU CA C S KHM BNH, CHA BNH

iu 59. V tr php l v thnh phn ca Hi ng truyn mu ca cs khm bnh, cha bnh

1. Hi ng truyn mu l hi ng chuyn mn c gim c c s khmbnh, cha bnh quyt nh thnhlp.

2. Hi ng truyn mu (Hi ng) gm cc thnh phn sau:

a) Ch tch hi ng: l Gim c hoc Ph gim c ph trch chuyn

mn;b) Ph ch tch hi ng: l Ph gim c hoc Trng phng K hoch

tng hp;

c) Th k hi ng: Trng phng K hoch tng hp hoc ngi phtrch c s pht mu;

d) Cc y vin hi ng gm i din cc khoa,phng:T chc cn b, Khoch tng hp, iu dng, Dc v cc khoa lm sng c s dng mu.

3. Hi ng c th kt hp vi Hi ng thuc v iu tr trn c s iu

kin thc t c b sung thnh vin, chc nng, nhim v ca Hi ng theo Khon2 iu ny v iu 60Thng t ny.

iu 60. Chc nng, nhim v ca Hi ng truyn mu

1. Chc nng:

Hi ng truyn mu c chc nng t vn cho lnh o c s khm bnh,cha bnh v truyn mu an ton, hp l v hiu qu.

2. Nhim v:

a) Ch o xy dng v thm nh cc nguyn tc, quy nh, quy trnh,hng dn c th v truyn mu ph hp vi cc hot ng xt nghim, iu trlm sng ca c s khm bnh, cha bnh;

b) Ch o xy dng k hoch s dng mu v ch phm mu hng nm;

c) xut cc gii phpci thin cht lng hot ng truyn mu; cc k

hoch pht trin hot ng truyn mu, b sung trang thit b, p dng cc k thutmi;

d) xutvict chc o to, tp hun cc quy trnhchuyn mn v quynh v truyn mu;


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) Gim st, phn tch, tng hp v bo co cc tai bin c lin quan n

truyn mu;e) nh gi vic thc hin cc quy trnh, quy nh hot ng truyn mu

ph hp vi iu kin ca c s khm bnh, cha bnh;

g) Thc hin s kt, tng kt v bo co nh k 06 thng v 12 thng.

3. Hot ng:

a) Hi ng lm vic theo nguyn tc tp th, quyt nh theo a s v ccvn lin quan n hot ng ca Hi ng. Trng hp c kin khc bit, s

phiu ca cc thnh vin hi ng bng nhau th Ch tch Hi ng l ngi quyt

nh cui cng. kin khc bit c bo lu v ghi vo bin bn lm vic ca hing. Cc thnh vin ca Hi ng lm vic theo ch kim nhim;

b) Hi ng hp nh k mi qu mt ln. Trng hp hp t xut doCh tch hi ng quyt nh;

c) Bin bn hp Hi ng phi ghi y kin ca tng thnh vin pht biu ti phin hp v phi c y ch k ca Ch tch v Th k Hi ng.

d) Ch tch Hi ng quy nh hot ng c th v phn cng nhim v chocc thnh vin Hi ng.

Chng IXLU GI H S V CH BO CO

iu 61. Lu gi h s

Lnh oc s truyn mu, c s khm bnh, cha bnh, c spht muphi t chc thc hin lu gi ti liu, h s theo cc yu cu sau:

1. Lu gi h s ti c s truyn mu:

a) Ti liu lin quan n hot ng tip nhn mu:

- Bng hi tnh trng sc kho ngi hin mu theo mu quy nh ti Phlc 2ban hnh km theo Thng t ny;

- H s sc kho ngi hin mu theo quy nh ti Ph lc 3 ban hnh kmtheo Thng t ny.

b) Ti liu lin quan n hot ng xt nghim, iu ch, bo qun, cp

pht mu, ch phm mu, bao gm:


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- M ca n v mu, ch phm mu;

- Loi, l, hn s dng, kim tra cht lng sinh phm xt nghim;- Kt qu v kt lun xt nghim;

- Ti liu v bo qun, kim tra v tiu hu mu bnh phm lu;

- Ti liu lin quan n ch phm mu t mi lt hin mu;

- Thng tin v tn loi ch phm mu, phng thc iu ch, trang thit b,dng c s dng, m hiu, nhm mu, ngy iu ch, ngy ht hn s dng, tn cs ly mu, xt nghim v iuch.

2. Lu gi h s ti c s khm bnh, cha bnh s dng mu:a) Ti liu lin quan n vic nhn mu t cc c s bn ngoi:

- Phiu giao nhn mu, ch phm mu;

- Phiu tr mu, ch phm mu (nu c).

b) Ti liu lin quan vic nhn mu t cc khoa, phng trong ni b c skhm bnh, cha bnh:

- Phiu d tr mu, ch phm mu;

- S cp pht mu, ch phm mu.c) Ti liu lin quan n vic xt nghim pht mu bo m ha hp min

dch truyn mu:

- Loi, l, hn s dng, kim tra cht lng sinh phm xt nghim;

-Kt qu nh nhm mu v xt nghim ha hp min dch;

- Kt qu xt nghim sng lc v nh danh khng th bt thng (nu c).

d) Ti liu lin quan n s dng mu ti c s khm bnh, cha bnh: s

d tr, cp phtmu, ch phm mu v phiu truyn mu;) Ti liu lin quan n vic x l khi c tai binlin quan n truyn mu:

- Ti c spht mu: bo co tai binlin quan n truyn mu; bin bngiao nhn n v mu, ch phm mu lin quan n tai bin; kt qu cc xtnghim iu tra tai binlin quan n truyn mu theo quy nh ti Khon 2 iu52 Thng t ny;

- Ti khoa, phng iu tr s dng mu: h s ghi nhn din bin tnh trngngi bnh v x tr, iu tr p dng; kt qu xt nghim cc mu mu, nc

tiu trc v sau khi xy ra tai binlin quan n truyn mu.


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3. Cc quy trnh lm vic, h s biu mu ghi chp, h thng kim sot ti

liu c lu tr bao gm dng vn bn thng thng v h thng ti liu in t.4. H s c lu tr 10 nm tnh t ngy cp nht thng tin ln cui cng.

5. H s ht hn lu tr c hy theo quy nh hin hnh.

iu 62. Ch bo co

Lnh oc s truyn mu v c s khm bnh, cha bnh s dng muphi t chc thc hin lp v gi bo co theo cc yu cu sau:

1. Bo co nh k hng nm:

a) Ni dung bo co theo quy nh ti Ph lc 14 ban hnh km theo Thngt ny;

b) Trc ngy 30/11 hng nm, cc c s y t c s dng mu (k c cc cs khm bnh, cha bnh t nhn) gi bo co theo quy nh ti im a Khon 1iu ny n cc s y t tnh, thnhph trc thuc trung ng, ng thi giVinHuyt hc - Truyn mu Trung ng;

c) Trc ngy 15/01 ca nm tip theo, Vin Huyt hc - Truyn muTrung ng bo co tng hp tnh hnh hot ng truyn mu n B Y t.

2. Bo co t xut: thc hin theo ni dung yu cu ca c quan qun lhoc theo yu cu thc t m n v cn bo co ln cp trn.

Chng XTRCH NHIM THC HIN

iu 63. Trch nhim ca Cc Qun l Khm, cha bnh - B Y t

1. Ch tr hoc phi hp xy dng, sa i, b sung cc vn bn quy phmphp lut v hot ng truyn mu; xy dng chin lc, quy hoch, k hoch, ccchng trnh, d n; xy dng tiu chun quc gia,quy chun k thut, hng dnchuyn mn c lin quan n truyn mu, trnh B trng B Y t hoc cp cthm quyn xem xt, quyt nh.

2. Ch o, t chc, hng dn, kim tra thc hin cc vn bn quy phmphp lut, chin lc, quy hoch, k hoch, cc quy nh chuyn mn, quy chunk thut quc gia, qun l cht lng i vi cc c s truyn mu, cc c s khm

bnh, cha bnh s dng mu.


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3. Ch tr hoc phi hp thm nh cc iu kin cho php ng dng cc k

thut mi, k thut cao trong hot ngtruyn mu theo quy nh ca php lut.4. T chc thm nh viccp php, nh ch hot ng ca cc c s khm

bnh, cha bnh c hot ng truyn mu theo quy nh ca php lut.

5. Lm u mi t chc cc hi ng chuyn mn gii quyt cc vn v

chuyn mn, k thut, ch o, hng dn cc hot ng nghin cu khoa hc vhp tc quc t trong lnh vc hot ng truyn mu.

6. Ch o, hng dn, bi dng nng cao nng lc qun l nh nc v

chuyn mn nghip v cho cn b qun l trong hot ng truyn mu.7. Ch o, hng dn thc hin trin khai ng dng cng ngh thng tin,

thng k s liu, xy dng c s d liu trong qun l hot ng truyn mu.

iu 64. Trch nhim ca Vin Huyt hc - Truyn mu Trung ng

1. Lm u mi xut, tham mu, kin ngh vi B Y t trong vic xydng, sa i, b sung ccvn bn quy phm php lut v hot ng truyn mu ;xy dng chin lc, quy hoch, k hoch, cc chng trnh, d n; xy dng tiuchun quc gia, quy chun k thut, hng dn chuyn mn c lin quan n

truyn mu;2. Trin khai o to, hng dn, h tr chuyn mn, k thut lin quan n

hot ng truyn mu trong phm vi ton quc.

3. Trin khai cc nghin cu, nh gi v cht lng, phng cch s dngcc loi thuc th, sinh phm, thit b, dng cs dng trong hot ng truyn mutheo quy nh ca B Y t.

4. Trin khai ng dng cng ngh thng tin, thng k s liu, xy dng cs d liu qun l hot ng truyn mutrongphm vi ton quc.

5. Thc hin trin khai hot nggim st nguy c truyn mu trong phmvi ton quc.

6. Kim tra v nh gi hot ng cc c s truyn mu trong phm vi tonquc theo biu mu quy nh ti Ph lc 15ban hnh km theo Thng t ny.

7. Thc hinnghin cu, p dng khoa hc cng ngh trong truyn mu.

8. Tng hp, phn tch, bo co s liu kt qu hot ng truyn mu cacc c s truyn mu trong phm vi ton quc gi B Y t.


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65 Tc ca S , p c c g g

1. Ch o, t chc thc hin, qun l, kim tra, nh gi hot ng truynmu ca cc c s khm bnh, cha bnh v c s truyn mu trn a bn qun l.

2. Cn c vo nhu cu s dng mu ca cc c s khm bnh, cha bnh,tng hp, xy dngk hoch s dng mu hng nm ca a phng; ng thi

phi hp vi cc n v c lin quan trong vic vn ng hin mu tnh nguyn,bo m ngun cung cp mu cho cc c s khm bnh, cha bnh.

3. Kin ngh sa i, b sung cc quy nh, hng dn v chuyn mn,nghip v, qun l nhm khc phc cc bt cp lin quan n hot ng truyn mu.

4. Tng hp, phn tch, bo co s liu kt qu hot ng truyn mu cacc c s khm bnh, cha bnh v c s truyn mu trn a bn qun l gi CcQun l khm, cha bnh, B Y t.

iu 66. Trch nhim ca c s truyn mu

1. Tuyn truyn vn ng ngi hin mu tnh nguyn. Cung cp thng tincho ngi hin mu v nhu cu s dng mu, v nguy c ca cc bnh ly truynqua ng mu.

2. Gii thch v quy trnh ly mu, cc biu hin khng mong mun, tai bin

c th xy ra, cc xt nghim s thc hin trc v sau khi hin mu ; t vn ngihin mu cch t chm sc sc kho v cc dch v y t chuyn khoa.

3. Bo m b mt v kt qu khm lm sng v xt nghim. Thng bo chongi hin mu v kt qu khm lm sng, xt nghim khi c yu cu trc tip tngi hin mu.

4. Chm sc, iu tr cho ngi hin mu khi c cc tai binkhng mongmun xy ra trong v ngay sau hin mu.

5. Xy dng, ph duyt, trin khai, gim st thc hincc quy trnh, hngdn chuyn mn p dng ti c s truyn mu bo m an ton cho ngi hinmu v cht lng ca n v mu: ng k hin mu; ghi h s; ly mu an tonv v trng, gim thiu nguy c nhim khun; chm sc ngi hin mu; phngnga vx l an ton cc tai binc th xy ra ngi hin mu; xt nghim snglc cc tc nhn ly truyn bnh qua ng mu v nh nhm n v mu; iuch, bo qun, vn chuyn mu v ch phm.

6. Thc hin cc th tc trnh cp c thm quyn tn vinh, khen thng v bo m cc quyn li khc ca ngi hin mu theo quy nh ca php lut.


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7. T chc thc hin qun l, gim st nguy c trong truyn mu c quy

nh ti iu 57, iu 58Thng t ny.8. Phi hp vi cc c s khm bnh, cha bnhs dng mu trong vic:

a) Cung cp, vn chuyn, bo qun mu, ch phm mu an ton, ph hptheo nhu cu v s lng, chng loi ca c s s dng mu;

b) Cung cp cc thng tin v cc n v mu, ch phm mu c lin quan

n cc tai binxy ra ngi bnh nhn mu;

c) Tm hiu, iu tranguyn nhn cc tai binlin quan n truyn mu;

d) Xy dng ti liu, thc hin o to tp hun v s dng mu hp ltrong iu tr lm sng.

9. nh k hoc t xut kim tra, theo di v nh gi hot ng truynmu trong phm vi khu vc c giao qun l theo biu mu quy nh trong Phlc 15 ban hnh km theo Thng t ny.

10. Tng hp, phn tch, bo co kt qu thc hin hot ng truyn muca cc c s khm bnh, cha bnh trong khu vc c giao ph trch v CcQun l khm, cha bnh - B Y t v Vin Huyt hc - Truyn mu Trung ng.

11. Kin ngh sa i, b sung nhm khc phc cc bt cp lin quan n hotng truyn mu pht sinh trong qu trnh trin khai cc quy nh ca Thng t ny.

iu 67. Trch nhim ca c s khm bnh, cha bnhc s dng mu

1. Gim c c s khm bnh,cha bnhc s dng mu c trch nhim bom hot ng truyn mu an ton, hiu qu ti n v do mnh ph trch, bao gm:

a) T chc thnh lp Hi ng truyn mu theo quy nh ti Chng VIIIv hot ng xt nghim, cp pht, s dng ; qun l cc tai bin lin quan n

truyn mu c quy nh ti iu 50, iu 52Thng t ny; t chc n vphtmu ti c s khm bnh, cha bnh hoc c hp ng h tr chuyn mn vi cs khc c kh nng thc hin xt nghim ho hp min dch truyn mu;

b) Ch o, t chc xy dng v ph duyt cc quy nh, quy trnh, hngdn chuyn mn truyn mu lm sng ca c s khm bnh, cha bnh; t chco to cho cc nhn vin c lin quan v t chc thc hin truyn mu theo ngquy nh ph duyt;t chcgim st vic tun th cc quy nh, quy trnh ,hng dn trong phm vi c s khm cha bnh;


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c) Xem xt, phi hp v ch o gii quyt cc vn lin quan khi thc

hin cc cng vic quy nh ti im b, im c v im d Khon 8 iu 66 Thngt ny vi cc c s truyn mu;

d) T chc thc hin vic qun l, gim st nguy c trong truyn mu cquy nh ti iu 57, iu 58 Thng t ny;

e) T chc nh gi cht lng hot ng truyn mu v ci thin chtlng hot ng truyn mu trong phm vi nv theo Ph lc 15 ban hnh kmThng t ny;

g) Kin ngh sa i, b sung nhm khc phc cc bt cp lin quan n

hot ng truyn mu pht sinh trong qu trnh trin khai cc quy nh ca Thng t ny.

2. C spht mu thucc s khm bnh, cha bnh thc hin xt nghimho hp min dch truyn mu c trch nhim:

a) Thc hin cc quy nh hin hnh v ch o ca gim c c s khmbnh, cha bnh trong vic thc hin cc cng vic c lin quan quy nh tiKhon 1 iu ny;

b) Xc nh nhu cu, lp k hoch s dng v t chc phi hp thc hinvn chuyn, bo qun mu, ch phm mu an ton, ph hp theo nhu cu v slng, chng loi ch phm mu;

c) Thc hin cc quy nh c lin quan n trch nhim ca n v phtmu c quy nh ti Thng t ny.

3. Khoa, phng iu tr thc hin truyn mu lm sng:

a) Thc hin cc quy nh hin hnh v ch o ca gim c c s khm bnh, cha bnh trong vic thc hin cc cng vic c lin quan quy nh ti

Khon 1 iu ny;

b) Chun b phng tin, dng c, thuc d phng cp cu thc hintruyn mu v x tr kp thi khi xy ra tai bin;

c) Gii thch cho ngi bnh hoc ngi nh ca ngi bnh v li ch vnguy c c th xy ra do truyn mu. Trong trng hp khng th gii thch chongi bnhv ngi nh th phi ghi r l do vo bnh n;

d) Thc hin cc quy nh c lin quan n trch nhim ca khoa, phngiu trc truyn mu c quy nh ti Thng t ny.


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iu 68. Trch nhim ca ngi ng k hin mu

1. Tr li trung thc v tnh trng sc kho v chu trch nhim v ni dungtr li ca mnh.

2. K xc nhn hiu r cc thng tin v t nguyn hin mu, sau khi cgii thch v in vo bng hi tnh trng sc khe ngi hin mu theo quy nh tiKhon 2 iu 7Thng t ny.

3. Khng li dng vic hin mu khm sc khe, xt nghim min ph.

4. T gic khng hin mu nu xt thy bn thn khng iu kin hinmu theo quy nh ti iu 4, iu 5, iu 6 Thng t ny. Khng che giu cc

nguy c mc bnh ca bn thn khi ng k, tham gia hin mu.5. Sau khi hin mu, cnbo ngay cho c s tip nhnmu nu t pht hin

thy bn thn c nguy c mc bnh vim gan, nhim HIV v cc bnh ly truyn khc.

iu 69. Trch nhim ca ngi bnh c truyn mu

Cung cp cc thng tin chnh xc v tnh trng sc kho ca c nhn h trnhn vin y ttrong vic ch nh, theo di v x tr cc tai bin(nu c).

Chng XIIU KHON THI HNH

iu 70. L trnh thc hin

Vic thc hin xt nghim sng lc HIV-1, HIV-2, vi rt vim gan B v virt vim gan C bng k thut NAT quy nh ti im g Khon 4 iu 14 Thng tny v xt nghim sng lc khng th bt thng quy nh ti im c Khon 4iu 14 Thng t nyc thc hintheo l trnh nhsau:

a) Cc c s truyn mu trna bn thnh ph H Ni, tnh Tha Thin -Hu, thnh ph H Ch Minh v thnh ph Cn Th phi thc hin trc ngy 01thng 01 nm 2015;

b) Cc c s truyn mu trn a bn cc tnh, thnh ph Thi Nguyn, HiPhng, Thanh Ho, Ngh An, Nng, KhnhHo, c Lc, Bnh nh phi thchin trc ngy 01 thng 01 nm 2017;

c) Cc c s truyn mu cn li trn ton quc phi thc hin trc ngy 01

thng 01 nm 2018.


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Ph lc 1DANH MC CC THUC C NGUY C GY T BIN DI TRUYN

KHNG C S DNG NGI HIN MU(Ban hnh km theo Thng t s 26/2013/TT-BYT ngy 16/9/2013

ca B trng B Y t)

1. Nhng ngi khng c hin mu k t khi s dng thuc trong thnh phn c mt trong cc cht sau:

a) Etretinate (th d: Tegison);

b) Acitretin (th d: Neotigason, Soriatane);

c) Hc mn tng trng chit xut t tuyn yn;

d) Insuline chit xut t b.

2. Nhng ngi phi tr hon hin mu trong 12 thng k t thi imngng s dng thuc trong thnh phn c mt trong cc cht sau :

a) Dutasteride (th d: Avodart, Avolve, Jalyn);

b) Tim, truyn khng th chng vim gan B.

3. Nhng ngi phi tr hon hin mu trong 03 thng k t thi imngng s dng thuc trong thnh phn c mt trong cc cht sau:

a) Finasteride (th d: Proscar, Propecia);

b) Isotretinoin hoc 13-cis-retinoic acid (th d: Accutane, Sotret, Claravis,Amnesteem);

c) Tretinoin (th d: Retin-A, Atralin, Renova, Avita, Altinac).

4. Nhng ngi phi tr hon hin tiu cu bng gn tch trong 7 ngy k tthi im s dng thuc trong thnh phn c mt trong cc cht sau:

a) S dng thuc c cha acid acetyl salicylic (th d: Aspirin, Aspegic);

b) S dng thuc c cha clopidogrel (th d: Plavix);

c) S dng thuc c cha ticlopidine (th d: Ticlid);

d) S dng thuc c cha piroxicam (v d: Feldene, Fasden, Dolonex,Faxiden, Roxam).

Ngi s dng cc thuc lit k Khon ny c th hin mu ton phn nut cc tiu chun khc theo quy nh.


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Ph lc 2MU BNG HI TNH TRNG SC KHO NGI HIN MU

(Ban hnh km theo Thng t s 26/2013/TT-BYT ngy 16/9/2013ca B trng B Y t)

B Y TC STRUYN MU.

CNG HA X HI CH NGHA VIT NAMc lp - T do Hnh phc

BNG HI TNH TRNG SC KHO NGI HIN MU

I. Phn thng tin hnh chnh :1.

H v tn:

2. Ngy sinh:

3.

Gii:4. Quc tch:5. Dn tc:6. Ngh nghip:

7. a ch trng hc, ni lm vic:

8. a ch thng tr:9. a ch lin lc:10.

in thoi (nu c):11.Email (nu c):

12.

S chng minh th / h chiu:13.S th hin mu:

II. Phn tr li ca ngi hin mu

1. Cm gic bn thn v sc kho hin ti ca ngi hin mu: 2.

Ngi hin mu c lm vic hoc tham gia cc hot ng nh: lm vic trn cao hocdi su (phi cng, li cn cu, cng nhn lm vic trn cao, ngi leo ni, th m, th

ln, thy th); Vn hnh cc phng tin giao thng cng cng (li xe but, li tu ho, litu thu); Vn ng vin chuyn nghip, ngi vn ng nng, tp luyn nng.3. S ln hin mu v thi gianhin mu ln gn nht:4. Tin s sc kho chung v bnh tt:

- Bnh tim mch:- Bnh gan, vim gan cc loi:- Bnh thn:-

Ni tit:- Bnh lao v h h hp:

-

Bnh mu:- Bnh tm thn, thn kinh:


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- St rt:- Giang mai:

-

HIV/AIDS:

- Cc bnh ly truyn khc:

-

Tin s v phuthut, cc th thut y t:- Tin s tim vacxin v cc ch phm sinh hc, truyn mu v ch phm mu; ghp cquan, t chc; xm tr; phi nhim vi mu v dch c th t ngi khc....5. Cc biu hin bt thng bnh l:- St cn khng r l!do:-

Ra m hi trm:-

Xut hin u, bu trn da hoc nim mc:-

Hch to ko di trn 1 thng:- Ri lon tiu ho:-

St trn 37o5 ko di trn 10 ngy:6. Tin s c s dng cc cht gy nghin:7. Tin s quan h tnh dc vi ngi mc vim gan, HIV/AIDS, ngi c quan h tnhdc ng gii:8. Tnh trng mang thai, nui con nh di 12 thng tui:9.

Nhng bnh, triu chng ang mc v thuc ang dng trong tun gn nht.10.

Li cam oan ca ngi hin mu v:- Hiu v tr li trung thc cc cu hi;

-

Khng hin mu nu t thy c nguy c ly truyn bnh cho ngi khc;- Cm thy tht s kho mnh;- Tnh nguyn hin mu;- Sau khi hin mu, nu pht hin thy bn thn c nguy c lm ly truyn bnh chongi c truyn, t nguyn bo ngay cho c s tip nhn mu v s khng an ton can v mu va hin.11.

Ngy thng nm in bng hi:12.Ch k v h tn ca ngi hin mu:13.Ch k v h tn ca ngi hng dn tr li bng hi:

III. Phn khm lm sng v xt nghim ngi hin mu1. Mch:2. Huyt p:3. Cc biu hin lm sng:4. Nng Hemoglobin:5. Kt qu xt nghim nhanh HBV:6.

Cc xt nghim khc, nu c:7. H tn/m s ngi khm lm sng v ngi thc hin xt nghim: 8.

Mu/thnh phn mu d kin hin: 9. Th tch: ml


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Ph lc 3MU H S QUN L THNG TIN NGI HIN MU

(Ban hnh km theo Thng t s 26/2013/TT-BYT ngy 16/9/2013ca B trng B Y t)

B Y TC S TRUYN MU.

CNG HA X HI CH NGHA VIT NAMc lp T do - Hnh phc

H S QUN L THNG TIN NGI HIN MU

I. Phn thng tin chung

1. H v tn:

2. M s ngi hin mu:

3. Ngy sinh:

4. Gii:

5. Dn tc:

6. S chng minh th /h chiu:

7. Ngy v ni cp:

8. a ch hin ti:

9. S in thoi c nhn:

10. Email:

11. Ngh nghip:

12. Ni lm vic:

13. Cho mu ln u nm:

II. Lit k cc ln hin mu v thnh phn mu

1. Ngy ng k hin mu:

Documents

Thong Tu Huong Dan Hoat Dong Truyen Mau So 26.2013.Tt .Byt 16.9.13