非特异性抗体致疑难配血的紧急处理策略及输血效果评价

Emergency treatment strategy and transfusion effect evaluation of difficult blood matching caused by non-specific antibodies

目的:探讨体内存在非特异性抗体患者的紧急输血策略,并对其输血治疗效果进行评价。方法:选取西安交通大学第一附属医院2021年1月—2024年2月出现非特异性抗体导致交叉配血困难的44例患者为研究对象,按疾病、血型进行归类,采用盐水试管法、微柱凝集法、凝聚胺法、抗球蛋白法等进行输血相容性检测,制定针对性的输血策略,并通过对比输血前后Hb的变化来评价输血治疗效果。结果:非特异性抗体的产生主要见于自身免疫性溶血性贫血和系统性红斑狼疮等自身免疫性疾病。非特异性抗体患者的Rh血型分布为DCCee占比最高,占50%,其次是DCcEe,占18.18%。选择ABO和Rh血型相匹配或少于患者抗原的洗涤红细胞,41例患者采用“最低不相合”原则进行输血,31例(75.61%)患者输血效果显著,9例(21.95%)患者输注部分有效,1例(2.44%)患者输注无效。结论:ABO和Rh表型匹配输血可有效降低输血不良反应的发生,提高输血治疗效果。

Objective: To explore emergency blood transfusion strategies for patients with non-specific antibodies in the body and evaluate the effectiveness of blood transfusion treatment. Methods: 44 patients with non-specific antibodies causing difficulty in cross matching in our hospital from January 2021 to February 2024 were selected as the research subjects. They were classified according to disease and blood type, and transfusion compatibility tests were conducted using saline test tube method, microcolumn agglutination method, polyamine method, anti globulin method, etc. Targeted transfusion strategies were formulated, and the effect of transfusion treatment was evaluated by comparing the changes in Hb before and after transfusion. Results: The production of non-specific antibodies was mainly seen in autoimmune diseases such as autoimmune hemolytic anemia and systemic lupus erythematosus. The Rh blood group distribution of non-specific antibody patients was DCCee, accounting for 50%, the highest proportion, followed by DCcEe, accounting for 18.18%. Selection of washed red blood cells with ABO and Rh blood types that matched or were less than the patient's antigen, and using the "lowest mismatch" principle for transfusion, 31 patients(75.61%) showed significant transfusion effects, 9 patients(21.95%) partially effective, and 1 patient(2.44%) had ineffective transfusion. Conclusion: ABO and Rh phenotype matching transfusion can effectively reduce the occurrence of transfusion adverse events and improve the effectiveness of transfusion treatment.