130例儿童输血不良反应回顾性分析

Retrospective analysis of 130 pediatric transfusion cases with adverse transfusion reactions

目的通过对儿童输血不良反应的调查分析,探讨儿童输血不良反应的特点及降低不良反应的措施。方法收集我院2016年1月—2017年12月7 268名儿童患者输血病历资料,统计分析儿童输血不良反应的特点,对输血不良反应分级评估。结果在输血14 347人次中不良反应130例,不良反应率为0. 91%;各种血液成分引起的输血不良反应率中单采血小板最高,为3. 6%,高于其它血液成分;不良反应类型中最常见的是过敏反应,占85. 4%,其次是非溶血性发热占9. 2%;儿童在不同年龄不良反应率的差异具有统计学意义,在4岁及以上发生率高于其他年龄段,性别比较无统计学差异。分级评估：轻中度输血不良反应占96%（125例）,自行缓解或临床干预后迅速缓解;与输血相关性极高的占92. 3%（120例）,基本确定患者症状由输血原因导致。结论儿童输血不良反应发生率高于文献报道成人,应严格掌握儿童输血指征,避免不必要的输血;增加不良反应分级评估,可提高对输血不良反应判断的准确性及严谨性,保证用血安全。

Objective To explore the characteristics and propose potential effective solution for adverse transfusion reactions in children.Methods 7 268 pediatric transfusion cases recorded between Jan 2016 to Dec 2017 in Wuhan children＇ s hospital were analyzed to evaluate the current status of adverse reactions. Results 130 adverse reaction eases were found in a total of 14 347case with an adverse reaction rate of 0. 91%.Component wise, adverse reactions caused by platelet issues accounted for the most part of the total cases at 3.6%. The most common cause of these reactions was allergy, accounting for 85.4%, followed by febrile non-hemolytic at 9. 2%.Age was considered a significant factor affecting the adverse reaction rates. Children aged 4 presented much higher reaction rate then other ages. No statistically significant differences were found regarding genders. Case degree ranking： 125 cases were mild or moderate reactions,which were self-mitigated or rapidly relieved after clinical intervention, accounting for 96%; 120cases showed extremely high correlation with transfusion issues, accounting for 92. 3%. Conclusion The rate of adverse transfusion reactions in children is higher than that in adults at present. Clinicians must carefully examine the symphtons and avoid unnecessary blood transfusion. With the help of a grading system, accurate and precise judgment are more likely to be made and misdiagnosis can be avoided, which ultimately improve transfusion safety.