不规则抗体筛查阳性患者紧急抢救输血20例分析

摘要

Objective To retrospectively investigate the patients for the emergency rescue blood transfusion who presented positive antibodies and to evaluate the effect of "recommended regimens" in clinical transfusion.MethodsInform-ation of the individuals was collected in Handan area from June 2014 to May 2016, and irregular antibodies were screened and patients with positive antibodies for emergency rescue blood transfusion were evaluated for the application effect based on "recommended regimens ".Results Twenty cases of emergency rescue group and31 cases of blood transfusion showed a total efficiency of 77.4%, following31 times of transfusion with 126 U red blood cells (4 U on average). Eighty three cases received 137 times of transfusion after specific antibodies were identified,with a total efficiency of 86.9%. No obvious difference was seen between the two groups(χ2=1.78,P>0.05).Conclusion It is relatively safe for the patients with positive irregular antibodies who need emergent blood transfusion to use the same blood type and negative blood cross-matching, or to use O type and negative cross-matching. The present investigation suggests that there is no difference of blood transfusion efficiency between the patients with emergent transfusion and normal transfusion.%目的 通过回顾性调查不规则抗体筛查阳性患者的紧急抢救输血情况,追踪评价《推荐方案》在临床输血中的应用效果.方法 统计邯郸地区2014年6月~2016年5月不规则抗体筛查阳性患者的紧急抢救输血情况,对遵循《推荐方案》的病例,分析评价其应用效果.结果 不规则抗体筛查阳性患者,紧急抢救输血病例(以下称"紧急抢救组")20例,输血31次,输注红细胞126 U,平均输注4 U,总有效率77.4%;鉴定出抗体特异性后再输血病例(以下称"正常程序组")83例,共输血137次,有效率86.9%,紧急抢救组和正常程序组的差异无统计学意义(χ2=1.78,P>0.05).结论 对于不规则抗体筛查阳性患者紧急抢救输血,采用与患者ABO、RhD/C/c/E/e同型且交叉配血试验阴性的供者红细胞输注或O型、RhD/C/c/E/e且交叉配血试验阴性的供者红细胞输注,都是相对安全的;回顾性调查显示不规则抗体筛查阳性患者的紧急抢救组与正常程序组的输注有效性的差异无统计学意义.因此,《推荐方案》是可行且必要的.