157例非传染性输血反应相关因素的回顾性调查

Retrospective investigation on 157 cases of related factors of non-infectious blood transfusion adverse reactions

目的探讨影响非传染性输血反应的相关因素,以提高医护人员对输血不良反应的认识,采取针对性的预防措施。方法对2009年1月-2013年12月在本院接受输血治疗的30 367患者的信息,包括性别、年龄、输血史、输血前用药、血液制品、原发疾病及输血不良反应第1症状在不同时间段的发生情况,做回顾性调查分析与统计学比较。结果本组接受输血治疗的患者的非传染性输血不良反应率为0.52%(157/30 367),非传染性输血反应的第1症状主要为发冷发热[占54.1%(85/157)]、荨麻疹或面部潮红[占35.7%(56/157)];发生在<15和≥15min的非传染性输血不良反应所占比例为33.4%(53/157)vs 66.6%(104/157)(P<0.05)。输血前用药病历占输血总病历的41.1%,输血前有、无预防性用药者的非传染性输血不良反应率无明显差异(P>0.05)。女性受血者、输注全血者、输血≥3次这及恶性疾病患者的非传染性输血反应率较高(P<0.05)。结论输血前预防性用药不宜常规使用;女性患者、输血≥3次者和/或恶性疾病的患者输血治疗时需要医护人员加强监护,避免输注全血,而根据病情选择适合的成分血输注,以减少非传染性输血反应的发生。

Objective To investigate the factors affecting the non-infectious blood transfusion adverse reactions,to improve medical professionals’ understanding on the adverse reactions of blood transfusion,and to take preventive measures.Methods The information of 30 367 patients who received blood transfusion in our hospital from January 2009 to December2013,including sex,age,history of blood transfusion,blood transfusion,blood products,primary diseases and adverse reactions of blood transfusion in different time were analyzed retrospectively. Results The rate of non-infectious adverse reactions in this group who received blood transfusion was 0. 52%（ 157 /30 367）. Primary non-infectious blood transfusion adverse reactions were predominantly fever and chill [accounted for 54. 1%（ 85 /157） ] and urticaria and facial flushing [accounted for 35. 7%（ 56 /157） ]. The rate of non-infectious adverse reactions that occurred in 〈 15 and more than or equal to15 min accounted for 33. 4%（ 53 /157） and 104 /157,respectively（ P 〈 0. 05）. The medical records of the patients before transfusion accounted for 41. 1% of the total medical records,and there was no significant difference in the non infectious blood transfusion adverse reaction rate（ P 〉 0. 05）. Female blood recipients,whole blood recipients,patients who have received blood transfusion for more than three times in history,and patients with malignant non-infectious disease had higher rate of adverse reaction due to transfusion（ P 〈 0. 05）. Conclusion Preventive medication should not be routinely taken before blood transfusion. Before transfusion,paramedics should strengthen monitoring of female patients,those who have received blood transfusion more than three times and / or patients with malignant disease in order to avoid unreasonable transfusion of whole blood,but also should take into consideration of suitable composition blood transfusion,in order to reduce the non infectious blood transfusion reaction.