利用两次血型制减少ABO不相容输血风险的研究

Reducing the risk of ABO incompatibility by two specimen policy

目的评估两次血型制在防止标本差错导致ABO不相容输血中的作用。方法对于需要或可能需要输血的患者,实施输血前采集2份单独的标本测定ABO/RhD血型。记录和分析输血前标本中错误标识和错误采集的比率。结果2007年7月—2009年6月,共接收到79115人份输血前相容性测试标本,检出273份错误标识的标本,错误标识标本比为1/290;校正的错误采集标本比为1/1485(基于47507份多次标本中检出23份错误采集标本,校正因子为1.3912)。在23份错误采集的标本中,9份(39%)可导致ABO不相容的红细胞输注。结论两次血型制可减少因标本错误标识和错误采集所致ABO不相容输血的风险。

Objective： To evaluate the effectiveness of using two specimens for ABO grouping on the prevention of ABO-incompatible transfusions caused by sample errors. Methods A two specimen policy for blood samples of pre-transfusion testing was implemented from July 2007. This policy was defined as that for patients requiring transfusion or likely to require transfusion, ABO group was determined twice on 2 separate-samples. The rate of mislabeled samples and miscollected samples prior to blood transfusion were recorded and analyzed. Results From Jul2007 to Jun 2009, 79 115 samplesfor pre-transfusion compatibility testing were accepted. A total of 273 samples were identified as mislabeled. The rate of mislabeled samples was 1 in 290. The rate of miscollected samples with correction for silent errors was 1 in1 485 （23 miscollected samples of 47 507 repeat samples, with a correction factor of 1. 391 2）. Of the 23 miscollected samples detected by double-step typing policy, 9 cases （39%） could have caused ABO-ineompatible transfusions. Conclusion The risk of ABO-ineompatible transfusions caused by mislabeled and miscollected samples can be reduced by two specimen policy.