360例紧急输血预案病例的输血情况分析

Analysis of the emergency transfusion plans in 360 transfusion cases

目的探讨紧急情况下不同输血预案的安全性及可行性。方法回顾性分析了四川大学华西医院2011-2016年启动紧急输血预案的360例输血病例,A预案为输血科收到输血申请后立即发放O型Rh D阳性血和/或AB型血浆,B预案为发放凝聚胺法交叉配血相合的ABO同型的血液,统计分析2种预案的血液发放时间、死亡率、红细胞及血浆用量、输血前血液指标,同种抗体检出情况以及溶血反应发生率。结果 A预案组平均发血时间为5 min,B预案组平均发血时间为16 min,2组死亡率、用血量、输血前血红蛋白及血小板计数差异有统计学意义,B预案有2例患者查出抗-E,全部病例均为Rh阳性,无1例发生溶血性输血反应。结论 2种紧急输血预案对不同临床情况的紧急失血患者的输血抢救均提供了保障,验证了O型Rh D阳性血作为紧急失血患者的输血抢救通用血(universal blood)的安全性及有效性。

Objective To analyze the feasibility and safety of our emergency transfusion plan. Methods 360 transfusion cases which launched the emergency transfusion plan from 2011 to 2016 in West China Hospital, Sichuan University were reviewed. Plan A involved O＋ RBCs and/or AB plasma without crossmatching （uncrossmatehed RBCs） which were directly released. Plan B involved RBCs with the same blood group of the patients, which were crossmatched with MPT methed and were released. The time from transfusion requisition form received to blood released （turnaround time, TAT） , mortality rate, the amount of blood used, pre-transfusion Hb, Plt, PT, APTT, alloantibody and transfusion reactions were evaluated. Results The average TAT of plan A was 5 minutes, and for plan B, it was 16 minutes. The mortality rate, the amount of blood, pre-transfusion Hb, Ph, PT had significant difference between two groups. No alloantibodies and hemolysis reactions were found. Conclusion The emergency transfusion plans can guarantee the supply of blood in emergent circumstances.