非传染性输血不良反应临床分析

目的分析非传染性输血不良反应（BTAR）与各因素的相关性，探讨有效降低BTAR的方法。方法回顾性分析2010年10月至2017年10月18537例次受血者的临床资料，分析BTAR总发生率（％），BTAR与不同项目（执行2012《医疗机构临床用血管理办法》前后、类型、血液品种、受血史、受血者性别、受血者年龄）间的关系及比例。结果185374例次输血患者，397例BTAR，总发生率2．14％；执行后BTAR发生率1．00％，显著低于执行前3．08％（P〈0．05）；执行后成分输血占4458％，显著高于执行前2006％（P〈0．05）；执行后急性溶血发生率000％，显著低于执行前1．59％（P〈0．05）；执行前后，输血相关性过敏反应比例均显著高于其他BTAR类型（P〈0.05）；多次受血史患者BTAR发生率7305％，显著高于初次受血者。受血者性别、年龄与BTAR发生率，无明显相关性（P〉0.05）。结论BTAR是输血的必然风险。规范输血，可有效降低BTAR发生率。

Objective To analyze the correlation between non-contagious transfusion adverse reaction and various factors, and to explore the effective method to reduce BTAR. Method The clinical data of 18,537 cases of blood receiving from October 2010 to October 2017 were analyzed retrospectively. The total incidence of BTAR （%）, the relationship and proportion of BTAR with different projects （Implementation of the 2012 ＂management methods of clinical blood use in medical institutions＂ before and after, types, blood types, history of blood transfusion, sex of recipients, age of recipients） were analyzed. Results In 18,537 patients with transfusions, 397cases of BTAR, total incidence was 2.14%; BTAR incidence （ 1.00% ） after execution was significantly lower than before （ 3.08% ） （P〈0.05） . After implementation blood components （ 44.58% ） was significantly higher than the previous （ 20.06% ） （ P〈0.05 ） . After implementation hemolysis （ 0.00% ） was significantly lower than before （ 1.59% ） （ P〈0.05 ） . Before and after the implementation of the transfusions, the ratio of allergic reactions to blood transfusion was significantly higher than that of other BTAR types （ P〈0.05 ） .The incidence of BTAR （ 73.05% ） was significantly higher than that in patients with first blood transfusion. The gender, age and BTAR incidence of transfusions had no inevitable correlation （ P〉0.05 ） . Conclusion BTAR is an inevitable risk of blood transfusion standardized blood transfusion can effectively reduce the incidence of BTAR.