사혈(瀉血 Venesection)
병의 치료를 목적으로 환자의 혈액을 주사기를 써서 체외로 뽑아내는 일.
방법은 100cc의 주사기와 주사침을 소독하고 혈액응고를 막기 위해 멸균한 10% 시트르산나트륨용액에 적셔두었다가 주정맥(肘靜脈)을 찔러 100~300 cc의 혈액을 서서히 흡인제거한다.
뇌출혈, 고혈압, 심부전 외에, 폐수종, 요독증, 적혈구증다증 등이 있는 환자에게 실시한다.
울혈(鬱血)이나 부종(浮腫)을 경쾌하게 하고, 심장순환계의 부담을 경감시켜 효과를 보이는 수가 많다.
동양의학적 사혈(瀉血)의 의미는?
사혈(瀉血)은 피를 쏟아낸다는 뜻인 데, 한방적 의미는 어혈(瘀血 궂은피, 또는 나쁜피)을 제거하고 울혈(鬱血 뭉쳐있는 피)을 풀어주는 의미가 되겠습니다.
* What is Phlebotomy?
Phlebotomy is the act of drawing or removing blood from the circulatory system through a cut (incision) or puncture in order to obtain a sample for analysis and diagnosis. Phlebotomy is also done as part of the patient''''''''''''''''s treatment for certain blood disorders. |
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- Treatment
Phlebotomy that is part of treatment (therapeutic phlebotomy) is performed to treat polycythemia vera, a condition that causes an elevated red blood cell volume (hematocrit). Phlebotomy is also prescribed for patients with disorders that increase the amount of iron in their blood to dangerous levels, such as hemochromatosis, hepatitis B, and hepatitis C. Patients with pulmonary edema may undergo phlebotomy procedures to decrease their total blood volume. |
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- Diagnosis
Phlebotomy is also used to remove blood from the body during blood donation and for analysis of the substances contained within it. |
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- Precautions
Patients who are anemic or have a history of cardiovascular disease may not be good candidates for phlebotomy. |
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* Description
Phlebotomy, which is also known as venesection, is performed by a nurse or a technician known as a phlebotomist. Blood is usually taken from a vein on the back of the hand or inside of the elbow. Some blood tests, |
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| however, may require blood from an artery. The skin over the area is wiped with an antiseptic, and an elastic band is tied around the arm. The band acts as a tourniquet, slowing the blood flow in the arm and making the veins more visible. The patient is asked to make a fist, and the technician feels the veins in order to select an appropriate one. When a vein is selected, the technician inserts a needle into the vein and releases the elastic band. The appropriate amount of blood is drawn and the needle is withdrawn from the vein. The patient''''''''''''''''s pulse and blood pressure may be monitored during the procedure.
For some tests requiring very small amounts of blood for analysis, the technician uses a finger stick. A lance, or small needle, makes a small cut in the surface of the fingertip, and a small amount of blood is collected in a narrow glass tube. The fingertip may be squeezed to get additional blood to surface.
The amount of blood drawn depends on the purpose of the phlebotomy. Blood donors usually contribute a unit of blood (500 mL) in a session. The volume of blood needed for laboratory analysis varies widely with the type of test being conducted. Therapeutic phlebotomy removes a larger amount of blood than donation and blood analysis require. Phlebotomy for treatment of hemochromatosis typically involves removing a unit of blood--or 250 mg of iron--once a week. Phlebotomy sessions are required until iron levels return to a consistently normal level, which may take several months to several years. Phlebotomy for polycythemia vera removes enough blood to keep the patient''''''''''''''''s hematocrit below 45%. The frequency and duration of sessions depends on the patient''''''''''''''''s individual needs |
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* Preparation
Patients having their blood drawn for analysis may be asked to discontinue medications or to avoid food (to fast) for a period of time before the blood test. Patients donating blood will be asked for a brief medical history, have their blood pressure taken, and have their hematocrit checked with a finger stick test prior to donation. |
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* Aftercare
After blood is drawn and the needle is removed, pressure is placed on the puncture site with a cotton ball to stop bleeding, and a bandage is applied. It is not uncommon for a patient to feel dizzy or nauseated during or after phlebotomy. The patient may be encouraged to rest for a short period once the procedure is completed. Patients are also instructed to drink plenty of fluids and eat regularly over the next 24 hours to replace lost blood volume. Patients who experience swelling of the puncture site or continued bleeding after phlebotomy should get medical help at once. |
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* Risks
Most patients will have a small bruise or mild soreness at the puncture site for several days. Therapeutic phlebotomy may cause thrombocytosis and chronic iron deficiency (anemia) in some patients. As with any invasive procedure, infection is also a risk. This risk can be minimized by the use of prepackaged sterilized equipment and careful attention to proper technique.
* Normal results
Normal results include obtaining the needed amount of blood with the minimum of discomfort to the patient. | | |
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