老年患者临床输血安全性的分析与探讨

Analysis of safety on blood transfusion in the elderly patients

目的探讨老年住院患者的临床输血及输血相容性检测的注意事项，分析老年住院患者的临床用血问题，预防或减少输血不良反应的发生，以期达到临床用血安全与有效。方法回顾性分析2009年1月至2011年12月在我院接受治疗的60岁以上老年患者的临床输血资料及我院老年患者择期手术预储式自体输血资料。结果共收集老年输血患者临床资料3549例，异体输血23877例次，出现输血不良反应84例次，均为发热或过敏反应；输注新鲜冰冻血浆时不良反应发生率最高，为0．55％；未见溶血反应的发生；预储式自身输血患者无输血不良反应发生。结论医疗机构应设定科学合理的用血原则，选择适宜的血液成分，减少老年患者输血不良反应的发生；同时应积极开展老年患者的自体输血工作，以杜绝抗原、抗体免疫所致的溶血、发热、过敏反应，减少经血液传播疾病的风险，节约人类稀缺资源——血液。

Objective To analyze the safety of blood transfusion in hospitalized senile patients, and to prevent or reduce adverse transfusion reactions. Methods The blood transfusion information of patients over the age of 60 years in our hospital from January 2009 to December 2011 were retrospective analyzed. The data of pre-storage type of autologous blood transfusion for elective surgery were also discussed. Results Among 3549 cases of elderly patients, there were totally 23877 times of allogeneic transfusion and 84 cases with blood transfusion adverse reactions of heating or allergic reactions. The adverse reaction rates occured most in the infusion of fresh frozen plasma （0.55%）. There was no hemolytic reaction, and transfusion adverse reactions occurred during stored blood autotransfusion. Conclusions Medical institutions should set the scientific and rational principle of blood use and select the appropriate blood components to reduce transfusion adverse events in the elderly patients. The autologous blood transfusion in the elderly patients should be actively pursued.