抗体筛选试验在交叉配血不合原因分析中的应用

Application of Antibody Screening Test in Causes Analysis of Incompatible Cross Matching

目的探讨交叉配血不合的原因，提高输血的安全性和有效性。方法选择2008年4月1日至2011年12月31日，本院收治需行输血治疗患者中，输血前凝聚胺法交叉配血结果不合患者91例为研究对象。根据凝聚胺法交叉配血不合的原因，将这91例患者分为人为因素组（n=24）和标本因素组（n=67）（本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该伦理会批准，分组征得受试对象本人的知情同意，并与之签订临床研究知情同意书）。采用x。检验比较两组抗体筛选试验的阳性率，根据患者的抗体筛选试验和自身对照试验的结果，分析交叉配血不合的原因，针对不同原因选择相应的方法处理。结果交叉配血不合的人为因素组抗体筛选试验阳性率为4．3％，标本因素组抗体筛选试验阳性率为83．6％，两组间抗体筛选试验的阳性率比较，差异有统计学意义（X^2=47．4，P〈0．01）。结论交配血不合的主要原因是受血者标本方面的因素，联合抗体筛选试验和自身对照试验结果对交叉配血不合的原因进行分析，通过选择相应的处理方法，可找到配血相合的血液输注，从而保证临床输血的安全性与有效性。

Objective To explore the causes of incompatible cross matching to improve the safety and effectiveness of blood transfusion. Methods From April 1st 2008 to December 31 2011, 91 patients whose cross matching results were incompatible before blood transfusion were included in the study. According to the causes of incompatible cross matching in polybrene method, these 91 patients were divided into human factors group （n= 24） and sample factors group （n= 67） （The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Jiangmen Central Hospital）. X^2 test was used to compare the antibody screening test positive rate of two groups. The appropriate approaches for different reasons were found through analyzing the results of antibody screening test and self-control test. Results Positive rate of antibody screening test in human factors group and sample factors group was 4.3 ~ and 83.6 ~, respectively. The difference between the two groups was existed significant difference （X2= 47.4, P~ 0. 01）. After processing by the appropriate method the blood could be suitable for transfusion. Conclusions Combined with antibody screening test and self control test results to analyze the causes of cross matching, matching of blood transfusions could be found by selecting the appropriate processing method.