特殊情况紧急抢救血小板ABO非同型输注回顾性分析

Retrospective analysis on the transfusion of allotype ABO and platelets under special circumstances and emergency situations

目的通过回顾性分析特殊情况紧急抢救时单采血小板ABO同型输注与异型输注2组病例,探讨单采血小板ABO非同型输注的必要性和可行性。方法统计邯郸地区8家医院非同型紧急抢救输注单采血小板情况,统计2014年12月-2015年11月单采血小板ABO异型输注率,分析比较单采血小板ABO同型和异型输注2组病例的临床输注指征及输注效果评价。结果共输注单采血小板804袋,ABO同型输注780袋,输注率97.01%,异型输注24袋,输注率2.99%;同型输注有效率75.26%,异型输注有效率41.67%,2组病例输注有效率差别比较有统计学意义。排除非免疫因素,同型输注有效率80.08%,异型输注有效率62.5%,2组病例输注有效率比较差异无统计学意义。结论单采血小板输注有效率ABO异型输注低于ABO同型输注,但排除非免疫因素,2组病例输注无显著性差异,因此,特殊情况紧急抢救时,ABO异型输注是必要的、可行的。

Objective To retrospectively analyze the infusion of identical ABO and allotypic ABO blood in two groups of patients under special circumstances and in need of emergency resuscitation,and to discuss the necessity and feasibility of apheresis platelet transfusion and rare ABO blood. Methods The data on infusion of platelets during emergency rescue in Handan hospitals were collected. The infusion rate of altered ABO shaped red blood cells and platelets were analyzed and compared with the infusion of identical ABO. Clinical indications for transfusion and infusion were evaluated. Results Among a total of 804 bags of platelets,780 bags received the same type of ABO infusion at an infusion rate of 97. 01%. Among the 24 infusion bags,the infusion rate was 2. 99%. The infusion rates of identical cells was 75. 26%. The infusion rates of altered shaped cells was 41. 67%. A significant statistical difference was observed in infusion rates among two groups of patients. Excluding non-immunological factors,the infusion rates of same type of blood achieved 80. 08%,while infusionrates of altered shaped cells reached 62. 5%. When comparing the infusion rates, the two groups did not demonstrate statistically significant difference. Conclusion The apheresis platelet transfusion is less efficient than infusion of the same type,but can exclude non-immunological factors. Consideringthe two groups were not significantly different,the emergency rescue by infusion of altered ABO cells is necessary and feasible.