无偿献血者ABO初筛血型错误原因分析

Errors in preliminary blood type screening for blood donors:Analysis of causes

目的正确的血型鉴定是保证临床输血安全的重要前提。文中旨在探讨无偿献血者初筛复检血型不符的原因,以便提出对策减少差错率。方法回顾性分析2009年1月1日至2015年12月31日南京军区南京总医院输血科无偿献血者114398人次。献血者血型初筛采用纸板法,血液采集后进行复检。分析筛选错误成因,统计初筛血型错误例数。并分析每年气温较高月份(7、8、9月)、气温较低月份(1、2、12月)、气温均衡月份(其余6个月)初筛错误发生率。结果共164例初筛血型错误,错误原因主要为血型鉴定错误(95.73%)。157例血型鉴定错误中,B、A抗原漏检率分别为43.95%、23.5%。气温较高月份初筛血型错误率(0.19%)较气温较低月份(0.12%)、气温均衡月份(0.12%)明显升高(P<0.05)。结论血型鉴定错误是造成ABO血型初筛错误的主要原因。应注意B抗原漏检,避免高温条件下初筛血型,有助于防止ABO初筛血型错误的发生。

Objective Correct identification of the blood type is an important prerequisite for ensuring the safety of clinical blood transfusion. This study was to explore the causes of blood type discrepancy of blood donors between preliminary screening and recheck and to propose some countermeasures for the reduction of errors. Methods This retrospective study included 114 398 cases of blood donation from 2009 to 2015. The blood types of the donors were preliminarily screened with the paper board and rechecked after blood collection. We investigated the causes and number of errors in preliminary blood type screening and analyzed the failure rates in the high-temperature months （July, August and September）, low-temperature months （December, January and February）, and moderate-temperature months （the other six months）. Results Preliminary blood type screening errors occurred in 164 of the cases, 157 （95.73%） in blood group identification, mainly misidentification of type B antigen （43.95%） and type A antigen （23.5%）. The rate of blood group identification errors was significantly higher in the high-temperature than in the low- and moderate-temperature months （0.19% vs 0.12% and 0.12%, P 〈0.05）. Conclusion Misidentification of types B and A antigens and high-temperature environment are the main causes of the errors in preliminary blood type screening for blood donors.