新生儿ABO、RhD配合型输血的实验研究

摘要

Objective:To investigate the safety and effectiveness of neonatal ABO or Rh (D) by using compatible blood transfusion through retrospective analysis of data from cases received compatible blood transfusion and type matched blood transfusion.Methods:The clinical data of 26 cases of neonatal compatible blood transfusion in Chinese Nanchang area from January 2014 to October 2016 were collected,and 26 cases of neonatal type-matched blood transfusion were selected according to ratio of 1 ∶ 1 cases.The efficiency and safety index of 26 patients compatible blood transfusion were compared with that of type-matched blood transfusion.The efficiency indexes included:patients'basic characteristics,red blood cell (RBC) count,hemoglobin (Hb) level,hematocrit (Hct),and the safety indexes contain Hb level and indirect bilirubin (IBiL) value before and after blood transfusion,irregular antibody screening,direct antiglobulin test (DAT) results and the adverse reactions of blood transfusion.Results:The age,sex,days of hospitalization between compatible blood transfusion and type matched blood transfusion were not statistically significantly different (P ＞ 0.05).The Hb level before transfusion,blood transfusion volume and the increase of Hb,Hct and RBC were not statistically significantly different between two groups (P ＞ 0.05).The values of Hb,Hct and RBC in 2 groups significantly increased at the day 1 after blood transfusion (P ＜ 0.05).No blood transfusion adverse reaction occurred in 2 groups.The IBiL value significantly decreased in compatible blood transfusion patients at the day 1 after blood transfusion (P ＜ 0.05).No new irregular antibodies had been detected after transfusion in all patients,and the others'DAT and screening for irregular antibodies were negative except 22 patients with neonatal hemolysis.The values of Hb and IBiL statistically significantly differenence were not in 12 patients between ld,3d,7d after blood transfusion (P ＞ 0.05).Conclusion:The efficiency and safety between compatible blood transfusion and type matched blood transfusion are the same in neonatal blood transfusion.Compatible blood transfusion is a safe and effective in clinical blood transfusion.%目的:通过新生儿ABO、RhD配合型输血与同型输血(下简称“配合型输血或同型输血”)的病例资料对照回顾性分析,探讨配合型输血在新生儿输血中的安全性和有效性.方法:收集南昌地区2014年1月-2016年10月26例新生儿红细胞配合型输血患者为配合型输血组,根据1∶1配比病例选取26例新生儿同型输血患者为同型输血组,对26例配合型输血组患者的基本资料,血红蛋白水平(Hb)、红细胞计数(RBC)、红细胞比容(Hct)等有效性指标和输血前、后Hb、不规则抗体筛查、间接胆红素(IBiL)值、直接抗人球蛋白试验(DAT)和输血不良反应等安全性指标与同型输血间进行对比分析,探讨配合型输血的安全性与有效性.结果:配合型输血与同型输血组间的年龄、性别、住院天数(d)差异均不具有统计学意义(P＞0.05).配合型输血与同型输血组间输血前Hb水平、红细胞输注量(m1)、1d后Hb、Hct、RBC增加值差异均不具有统计学意义(P＞0.05),2组输注红细胞1d后Hb、Hct、RBC均明显升高(P＜0.05).配合型输血与同型输血组均未发生输血不良反应;配合型输血组IBiL值较输血前明显下降(P＜0.05),输血后均未检出新的不规则抗体,除22名新生儿溶血病患者外DAT亦均呈阴性;12例配合型输血患者输血后1、3、7d的IBiL值、Hb水平间差异均不具有统计学意义(P＞0.05).结论:配合型输血与同型输血在新生儿输血治疗中具有同等的安全性和有效性,是一种安全有效的输血治疗途径.