119例输血不良反应原因及情况分析

Case analysis of 119 blood transfusion adverse reactions

目的分析和探讨输血不良反应原因及具体情况,为进一步搞好血液管理和输血安全提供重要依据与参考。方法采用回顾性调查研究方法,通过临床输血计算机自动化管理信息系统及其输血反应反馈资料等,对2012—2016年临床输血不良反应相关资料进行分类收集、整理、统计和分析。结果 2012—2016年54 808人次输用各种血液成分共88 232袋,有119例出现输血不良反应,其中发热反应32例,占26. 89%,过敏反应85例,占71. 43%,其他反应2例占1. 68%。红细胞、血浆、血小板、冷沉淀之间输血不良反应发生率比较差异有统计学意义（P〈0. 05）,红细胞悬液占发热反应的75%（24/32）,冰冻血浆占过敏反应的68. 24%（58/85）;发热反应以儿科和血液科发生率较高,过敏反应以烧伤整型患者占多数;发热反应与过敏反应患者反应时平均体温有统计学差异（P〈0. 05）。输血反应患者74. 79%（89/119）有输血史,女性中有输血史以及有妊娠史者占94. 59%（35/37）。80. 67%（96/119）的输血反应在输血时发生。结论输血反应多发生在老、幼、弱、病重、抵抗力差和反复输血与妊娠患者,以过敏反应较多见,大多数在输血过程中发生。要确实搞好科学合理用血,严格控制输血指征,注意反应重点群体,规范与熟练掌握各项输血操作规程与注意事项,完善血液预警系统,确保输血安全。

Objective To analyze and discuss the causes and specific conditions of adverse reactions to blood transfusion,providing important basis and reference for improved blood management and transfusion safety. Methods A retrospective investigation and research method was used to collect,sort,count and analyze the relevant data of clinical transfusion adverse reactions during 2012—2016 through the clinical blood transfusion computer automated management information system and the feedback data of blood transfusion reactions. Results A total of 88,232 bags of various blood components were delivered to 54808 patient during 2012—2016. 119 cases of adverse reactions occurred during blood transfusion. Among them,32 cases were febrile reactions,accounting for 26. 89%; 85 cases were allergic reactions,accounting for 71. 43%; 2 cases accounted for 1. 68% for other reactions. There was a statistically significant difference in the incidence of adverse reactions between red blood cells,plasma,platelets and cryoprecipitate（ P 0. 05）. Red blood cell suspension accounted for 75%（ 24/32） of the fever reaction,and frozen plasma accounted for 68. 24%（ 58/85） of the allergic reactions.; The incidence of febrile reactions was higher in pediatrics and hematology,and the majority of the patients with allergic reactions were burn-integers; there was a significant difference in the mean body temperature between patients with fever and allergic reactions（ P〈0. 05）. 74. 79%（ 89/119） of patients with transfusion reactions had a history of blood transfusion. The Females with blood transfusion history and pregnancy history accounted for 94. 59%（ 35/37）. 80. 67%（ 96/119） of the transfusion reactions occurred during transfusion. Conclusion Blood transfusion reactions occur frequently in the old,young,weak,severely sick,poor immune capability and repeated transfusions and pregnancy population. Allergic reactions are more common and most of them occur during blood transfusion. It is necessary to maintain scientific and rational use of blood. Strictly control the indications of blood transfusion. Carefully coping with high risk group populations and standardize/master the various blood transfusion procedures and precautions. Improve the blood warning system,and ensure blood transfusion safety;