75例疑难交叉配血原因分析及应对策略

Cause analysis and coping strategies of 75 cases of difficult cross matching

目的回顾性分析本院输血科75例疑难交叉配血原因及应对策略,以提高输血相容性检测技能,保障用血安全。方法选取2019年1月至2022年3月本院75例疑难交叉配血标本作为研究对象,根据患者的临床资料对交叉配血不合标本进行针对性处理。为了确保不漏检免疫球蛋白M(IgM)和免疫球蛋白G(IgG)抗体,交叉配血试验采用盐水法加凝聚胺法进行。结果75例疑难交叉配血中有40例(53.33%)主侧配血不合,15例(20.00%)次侧配血不合,20例(26.67%)主、次侧配血均不合。原因分别为不规则抗体阳性41例(54.67%),冷凝集素22例(29.33%),自身抗体6例(8.00%),患者血浆蛋白异常5例(6.67%),献血者红细胞直接抗人球蛋白试验阳性1例(1.33%)。结论疑难交叉配血的主要原因为不规则抗体阳性、冷凝集素、自身抗体。输血科工作人员应综合分析交叉配血不合的具体原因,并采取针对性处理措施,为患者选择相匹配的血液制品,确保患者输血治疗安全、有效。

Objective To retrospectively analyze the causes and coping strategies of 75 cases of difficult cross matching in the blood transfusion department of our hospital,so as to improve the skills of blood transfusion compatibility detection and ensure the safety of blood use.Methods From January 2019 to March 2022,75 cases of difficult cross matching blood samples in our hospital were selected as the research objects,and the cross matching incompatibility samples were given targerted processing according to the clinical data of the patients.In order to ensure that immunoglobulin M(IgM)and immunoglobulin G(IgG)antibodies were not missed,the cross matching test was performed by saline method and polybrene method.Results Among the 75 cases of difficult cross matching,there were 40 cases(53.33%)of main side mismatch,15 cases(20.00%)of secondary side blood mismatch,20 cases(26.67%)of primary and secondary blood were incompatible.The causes were irregular antibody positive in 41 cases(54.67%),cold agglutinin in 22 cases(29.33%),autoantibodies in 6 cases(8.00%),abnormal plasma protein in patients in 5 cases(6.67%),positive red blood cell direct antiglobulin test of blood donor in 1 case(1.33%).Conclusion The main causes of difficult cross matching are irregular antibody positive,cold agglutinin and autoantibodies.The blood transfusion department staff should comprehensively analyze the specific causes of cross matching incompatibility and take targeted treatment measures to select matching blood products for patients,so as to ensure the safe and effective blood transfusion treatment of patients.