临床常规Rh表型检测及配合性输血必要性和疗效探讨

Research on the necessity of Rh detection and the effect of blood transfusion

目的统计Rh表型不同分型在住院人群中的分布趋势,探讨常规检查患者和献血员Rh表型对临床输血必要性及实施Rh同表型配合性输血疗效对比观察。方法 Rh表型采用盐水法、凝聚胺法、微柱凝胶法3种检测方法,将患者和献血员Rh表型结果录入输血科计算机信息系统中,建立Rh表型数据库,计算机信息化自动配伍进行配合性配血。结果 48 539份血标本Rh阳性表型分布规律为CCDee>Cc DEe>Cc Dee>cc DEE>cc DEe>CCDEe>Cc DEE>cc Dee>CCDEE。对5 813例需要反复输血的患者,进行Rh配合性输血,无溶血性输血反应的发生,2组输血产生的Rh血型系统相关的不规则抗体生成由21例明显下降为3例,其抗体生成率由0.65%明显下降为0.12%,2组输血引起的输血反应由31例明显下降为9例,其输血反应率由0.96%明显下降为0.35%。结论对于需要反复输血的患者,Rh同型配合性输注可以在一定程度上减少及预防患者Rh血型系统不规则抗体的产生,有利于减少患者输血不良反应和风险,保证输血的安全性,提高输血疗效。

Objective To statistically analyze the distribution trend of Rh phenotypes in the hospitalized patients,to explore the necessity of routine examination of Rh phenotype in clinical blood transfusion and transfusion effect of Rh same phenotype transfusion. Methods Rh phenotype was confirmed by saline method,polybrene method,micro column gel method,and the results of Rh phenotype were recorded into the transfusion department of computer information system. To establish Rh phenotype database,to match with computer automatical compatiblity for cooperative crossmatching. Results Rh positive phenotype distribution of 48 539 cases of blood samples was CCDee 〉CcDEe 〉CcDee 〉ccDEE〉 ccDEe 〉CCDEe 〉CcDEE〉 ccDee CCDEE.5 813 patients requiring repeated blood transfusions accepted Rh cooperative transfusion,and non hemolytic transfusion reaction were found. The Rh- related irregular antibodies generated by blood transfusion in the 2 groups decreased significantly from 21 cases to 3 cases,and the antibody production rate decreased from 0. 65% to 0. 12%,transfusion reaction caused by blood transfusion in the 2 groups reduced from 31 patients to 9 cases; the transfusion reaction rate decreased from 0. 96% to 0. 35%. Conclusion For patients requiring repeated blood transfusion,Rh same phenotype infusion can reduce and prevent the formation of irregular antibody with Rh blood group system in patients,and is beneficial to reducing the adverse reaction and the risk of blood transfusion and ensure the safety of blood transfusion,which increases the transfusion effect.