目的：分析患者交叉配血不合的原因，并筛选适当的血液与患者进行紧急特殊配血。方法：ABO血型、Rh(D)血型鉴定采用微柱凝胶法，直接抗人球蛋白试验、Rh表现型鉴定采用试管法，抗体鉴定试验、交叉配血试验采用试管法和微柱凝胶法综合判定结果。结果：患者为A型， ccDEE型，患者血清与试剂谱细胞反应结果提示患者血清含有自身抗体合并抗-Mur、抗-C及其他暂未确定特异性的同种抗体。在160份献血者标本中筛选出10份C、e抗原阴性者与患者进行主侧配血试验，仅4份相合，患者输注该4份红细胞悬液后贫血症状得到有效改善。结论：患者血清罕见的同时检出自身抗体及抗-Mur、抗-C及其他暂未确定特异性的同种抗体。在紧急情况下，针对已明确特异性的同种抗体，利用实验室现有试剂血清对献血者进行抗原鉴定，将已知相应抗原阴性的献血者与患者进行配血，可减少试验中患者标本的需要量，缩短配血时间，减轻交叉配血工作量，进一步保证输血治疗的安全性。% Objective:To analyze the cause of crossmatching failure for one patient.Screening proper blood did emergency special matching with patient. Methods:ABO and Rh(D) blood typing adopting by gel microcolumn test.Direct antiglobulin test,Rh phenotype identify by test tub.Antibody identification test, crossmatching were done by test tube and gel microcolumn method.Results:The blood group of the patient was A,ccDEE.The result of reaction of the patient’s serum to the panel of reagent red blood cells in multiple reation media showed that the patient’s serum contained autoantibody combine with anti-Mur,anti-C and other alloantibody.In 160 donor’s specimen 10 copies were C,e antigen-negative.Thereinto only 4 copies were main side matching test consistency with patient.The patient’s anemia symptoms effectively improve after infusion this 4 red blood cell suspension.Conclusion:The patient’s serum contained autoantibody combine anti-Mur,anti-C and other temporary not determine the specificity alloantibody is rare.In view of the clear specific alloantibody,it can used by reagent serum to blood donor’s antigen appraisal in an emergency.In this way can reduce test patients specimen requirement,shorten matching time,reduce the cross matching workload,ensure the safety of transfusion treatment.
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