广州地区实施献血者归队效果评估

Evaluating the process of conducting Guideline for Deferral and Reentry of Blood Donors of Reactive Test Results (Second Edition) in Guangzhou Blood Center

目的对广州血液中心实施《反应性献血者屏蔽与归队指南(第二版)》的全过程进行分析,为完善指南提供参考。方法电话及短信通知2012年1月—2016年6月期间在本中心献血后,检测结果符合《反应性献血者屏蔽与归队指南(第二版)》中参加归队检测要求的献血者8 451名参加归队检测,对响应者进行包括HBsAg、抗-HCV、抗-HIVAgAb、抗-TP以及NAT的归队检测。采用多因素Logistic回归分析法分析参加归队检测及归队后再次献血的影响因素。配对t检验比较部分献血者归队前后的平均献血间隔期差异。结果 8 451名献血者中有7 918名收到归队建议的通知,其中2 972名献血者参与归队检测,响应率37.54%。献血者参加归队检测的血液检测结果总合格率为69.01%。机采献血者参加归队检测的意愿是全血献血者的1.506倍(OR 95%CI:1.270—1.786,P<0.05),固定献血者参加归队检测的意愿是固定献血者的1.721倍(OR 95%CI:1.545—1.916,P<0.05),大学以上教育程度的献血者参加归队检测的意愿是大学以下教育程度献血者的1.201倍(OR 95%CI:1.080—1.335,P<0.05)。2012—2014年归队献血者1 420名,机采献血者,固定献血者及高年龄组献血者归队后再次献血(截止到2016年12月统计)的意愿相对其相应对照组高,分别为:2.753倍(OR 95%CI:1.924—3.939,P<0.05);1.358倍(OR 95%CI:1.083—1.704,P<0.05);2.040倍(OR 95%CI:1.398—2.977,P<0.05)。755名献血者归队后献血间隔期比此前献血间隔期平均延迟83.68 d(t=-3.284,P<0.05)。结论献血检测结果假反应性的经历对献血者心理造成了一定的负面影响,《指南》还应加入专业的心理干预方面的内容;有条件的地方,应同时开展确诊实验,以减少对献血者的困扰;应通过更细致的服务促进假反应性献血者参加归队检测及再次献血。

Objective To evaluate the process for conducting Guideline for Deferral and Reentry of Blood Donors of Reactive Test Results(Second Edition)in Guangzhou Blood Center.Methods 8 451 blood donors who donated blood from January 2012 to June 2016 in Guangzhou Blood Center were called back to retest through telephone or SMS if they met the requirements of Guideline for Deferral and Reentry of Blood Donors of Reactive Test Results(Second Edition).They were suggested to participate retests for HBsAg,anti-HCV,anti-HIVAg/Ab,anti-TP and NAT.Multi-factor Logistic regression analysis was used to study the related factors of their willingness to participate retest and blood donation after reentry.For some of the above donors,Pair-t test was used to compare the average interval of blood donation before and after reentry.Results Among the 8 451 blood donors,2 972 of them responsed to retest suggestion,with a response rate of 37.54%.The total negative rate of retest was 69.01%.The platelet pheresis donors,regular blood donors and donors with college education background or above were more willing to have the retest than donors in other groups,with the differences of statistical significance.Among 1 420 blood donors who reentered into the list of eligible donors from 2012 to 2014,platelet pheresis donors,regular blood donors and elder donors were more likely to donate again after deferral,with statistical significant differences.The blood donation interval of the 755 non-first time donors after deferral was 83.68 days(T=-3.284,P<0.05)longer than before on average.Conclusion The experience of false reactive test results has a certain negative impact on the psychology of blood donors.The Guideline should also include the content of professional psychological intervention;if possible,we highly suggest that the confirmatory test should be carried out at the same time to reduce the blood donors’misgivings.More considerate services should be provided to facilitate the blood donors to reenter and donate again.