226例疑难血型鉴定及处理对策分析

Analysis of the strategy to identify 226 cases of suspicious blood types

目的探讨研究ABO疑难血型鉴定的处理对策,正确鉴定血型,确保临床输血安全。方法应用ABO疑难血型三步分析法,对本站2011-2014年接收的226例ABO正反定型不一致标本进行分析鉴定。结果在226例正反定型不一致标本中,人为原因造成的38例(16.81%);由于疾病本身或治疗因素造成的188例(83.19%)。其中因老年人、新生儿、先天性抗体缺陷、ABO亚型等生理因素导致的血液标本43例(22.87%);因自身免疫性溶血性贫血、淋巴瘤等疾病原因出现自身抗体,从而导致的正反定型不一致标本55例(29.26%);因输血史、妊娠史出现不规则抗体而导致的标本36例(19.15%);因多发性骨髓瘤、真性红细胞增多症等出现血浆蛋白异常而导致的30例(15.96%);因骨髓异常增生综合症、白血病等出现抗原减弱而导致的标本24例(12.77%)。结论应用ABO疑难血型三步分析法,能快速有效的解决疑难血型的鉴定,确保临床输血安全,值得我们推广应用。

Objective To investigate the appropriate strategy to identify suspicious ABO blood group,to correctly identify blood group,and to ensure safety of clinical blood transfusion. Methods A three step analysis was employed to identify226 cases of suspicious ABO blood groups,including inconsistent samples of ABO positive and negative serotypes,from 2011 to 2014. Results In the 226 cases of inconsistent positive and negative serotypes samples,38 cases were man-made causes（ 16. 81%）. 188 cases were attributed to disease or adverse effects from treatments（ 83. 19%）,among which 43 cases（ 22. 87%） were elderly or newborn,had congenital defects or ABO subtype physiological factors,55 cases（ 29. 26%） were inconsistent due to autoimmune hemolytic anemia or antibodies caused by lymphoma disease,36 cases（ 19. 15%） were due to irregular antibody from history of blood transfusion,history of pregnancy,30 cases（ 15. 96%） were due to multiple myeloma and abnormal appearing plasma protein from polycythemia vera,and lastly,24 cases（ 12. 77%） were due to myelodysplastic syndrome,leukemia and other hematological diseases caused by weak positive and negative blood serotypes. Conclusion The application of the three step method can effectively identify suspicious ABO blood groups and ensure the safety of clinical blood transfusion.