郑州市单采血小板输血反应统计分析及预防办法

Statistical analysis of platelet transfusion adverse reactions in Zhengzhou city and prevention methods

目的调查郑州市单采血小板输血反应的情况,指导临床合理输血,减少输血反应的发生。方法收集2013—2017年郑州市17家医院输血反应单资料,统计单采血小板输血反应例数。结果 17家医院共输注单采血小板161 072袋,发生输血反应89例,输血反应发生率0. 06%,其中最高1. 35%,最低0. 02%。按输血反应分类,过敏反应最多(占69. 7%),其次是非溶血性发热反应占(21. 3%);按疾病分类,急性淋巴细胞白血病最多(占15. 7%),其次是再生障碍性贫血(占13. 5%),再次是急性髓系白血病(占11. 2%)。非溶血性发热反应与采集血小板仪器关系:Amicus、Trima分别与MCS+995E2比较,P均<0. 01,Amicus与Trima比较,P>0. 05;过敏反应3种仪器两两比较,P均>0. 05。结论郑州市单采血小板输血过敏反应最高,其次是非溶血性发热反应。过敏反应与采集的血小板机器耗材无关,而非溶血性发热反应与采集的血小板机器耗材有关。减少过敏反应可采取将血小板重悬于PAS保存液中,输注Amicus和Trima生产的单采血小板可降低非溶血性发热反应。

Objective To investigate platelet transfusion reaction in Zhengzhou to improve blood transfusion quality and reduce blood transfusion adverse reactions. Methods The data of the blood transfusion adverse reactions of 17 hospitals in Zhengzhou during 2013 to 2017 were collected and statistically analyzed. Results A total of 161 072 bags of platelets were transfused in the 17 hospitals. There were 89 cases of blood transfusion adverse reaction with an incidence rate of 0. 06%. Among the 17 hospitals,the highest rate was 1. 35% while the lowest was 0. 02%. As for the adverse reaction types,the allergic reaction was the highest(69. 7%),followed by fever reaction(21. 3%). By diseases,acute lymphoblastic leukemia was the highest(15. 7%),followed by aplastic anemia(13. 5%) and acute myeloid leukemia(11. 2%). The relationship between heat reaction and platelet collection instruments: Amicus and Trima were compared with MCS+995E2 respectively and X^2 was 8. 205,10. 491 respectively,P<0. 01. Amicus vs Trima were 0. 454 with P>0. 05 respectively. Comparing the 3 instruments regarding allergic reaction: X^2 were 0. 842,0. 029,and 0. 554 respectively,P> 0. 05. Conclusion The allergic reactions in platelet transfusion in Zhengzhou were the highest causing adverse reactions,followed by non-hemolytic fever.Anaphylaxis was not associated with instruments and consumables,while non-hemolytic fever was related. To reduce allergic reaction,re-suspension of platelets in PAS preservation solution was adopted,and apheresis platelets from Amicus and Trima were used to reduce febrile non hemolytic transfusion reactions.