输血前不规则抗体筛查避免溶血性输血反应效果分析

Irregular antibody screening before transfusion in prevention of hemolytic transfusion reaction:an analysis of effect

目的:探讨患者在输血前进行不规则抗体筛查在避免免疫性溶血性输血反应中的预防效果,以提高临床输血的安全性。方法:选取2015年1月-2016年12月在某院输血前进行不规则抗体筛查的1 986例患者作为观察组,并选取2013年1月-2014年12月在某院输血前未进行不规则抗体筛查的1 988例患者作为对照组,分析观察组患者的不规则抗体检查情况并比较2组患者的免疫性溶血性输血反应反生情况。结果:观察组1 986例患者中,共筛查出24例不规则抗体阳性的患者,其中自身抗体4例,同种特异性抗体20例,总阳性率为1.21%。其中女性患者的阳性检出率高于男性,有妊娠史的女性阳性检出率高于没有妊娠史的女性,输血次数≥3次的患者阳性检出率高于输血次数少于3次的患者,有血液病的患者阳性检出率显著高于没有血液病的患者,各值间比较差异有统计学意义(P<0.05)。观察组患者的免疫性溶血性输血不良反应发生率为0.10%低于对照组溶血性输血反应发生率0.86%,2组比较差异有统计学意义(P<0.05)。结论:患者在输血前进行不规则抗体筛查,能够有效检出患者血液中的不规则抗体,从而减少或避免溶血性输血反应的发生,提高临床输血的安全性,值得临床上进一步推广应用。

Objective： To investigate the effect of irregular antibody screening before blood transfusion to prevent hemolytic transfusion reaction（ HTR） so as to improve the safety of clinical blood transfusion. Methods： 1986 cases undergoing irregular antibody screening before blood transfusion were chosen as a study group,and another 1988 patients without irregular antibody screening as a control group. The result of the irregular antibody test and immune hemolytic transfusion reaction of the two groups were observed and analyzed. Results： Among the 1986 patients in the study group,24 patients with irregular antibody positive were screened out,including4 cases of autoantibodies and 20 cases of specific antibodies,with a total positive rate of 1. 21%. The positive rate was higher in women than in men,higher in women with pregnant history than in women without the history,higher in those receiving more than 3 times of blood transfusion than in those less than 3 times,and higher in those with hematonosis than in those without the disease. The value differences between the two groups were statistically significant（ P〈 0. 05）. The incidence of immune hemolytic transfusion adverse reaction in the study group was 0. 10%,significantly lower than the control group＇s 0. 86%,the difference being statistically significant（ P〈 0. 05）. Conclusion： Irregular antibody screening before transfusion can effectively reduce or avoid the occurrence of HTR,and improve the safety of clinical blood transfusion. It is worthy of further clinical application.