57例交叉配血困难原因及临床输血策略

Causes and Clinical Blood Transfusion Strategies of 57 Cases with Cross Matching Blood Difficulty

目的分析临床输血检验中交叉配血困难的原因,并制定临床安全输血策略。方法便利选取该院2012年1月—2017年10月临床输血检验中57例交叉配血困难样本,对其交叉配血困难原因及输血策略进行回顾总结分析。结果选择的57例交叉配血困难样本中,输血史44例(77.19%),妊娠史28例(49.12%)。抗体检测结果显示不规则抗体阳性样本数39例(68.42%);其他ABO亚型样本数2例(3.51%);H抗原缺失1例(1.75%);血浆蛋白异常导致的交叉配血困难样本5例(8.77%),供血者原因2例(3.51),新生儿溶血1例(1.75%);因人为操作不当等因素致交叉配血困难样本3例(5.25%);不明原因4例(7.02%)。结论导致交叉配血困难的原因很多,除了输血前抗体检测外,其输血史、妊娠史、病史等疾病因素要予以重视,配血过程需要认真分析,综合考虑,确保临床用血安全。

Objective To analyze the causes of cross matching blood difficulty and make the clinical safety blood transfusion strategies. Methods 57 cases of samples with cross matching blood difficulty in the clinical blood transfusion test in our hospital from January 2012 to October 2017 were convenient selected, and the causes of cross matching blood difficulty and blood transfusion strategies were reviewed and analyzed. Results Of 57 samples, 44 cases had the blood transfusion history（77.19%） , and 28 cases had the gestational history （49.12%）, and the antibody test results showed that there were 39 cases with irregular antibody positive samples（68.42%）, and 2 cases of other ABO subtype samples （3.51%）, 1 case with deletion of H antigen（1.75%）, 5 cases with cross matching blood difficulty caused by the abnormal plasma protein （8.77%） , 2 cases due to blood donors（3.51%） , 1 case with neonatal hemolysis（1.75%）, 3 cases of cross matching blood difficulty samples due to improper operation（5.25%）,4 cases due to unknown reasons（7.02%）. Conclusion There are many causes of cross matching blood difficulty, and we should attach importance to the blood transfusion history, gestational history and disease history besides the test of antibody before the blood transfusion, and we should also carefully analyze and comprehensively consider various aspects and ensure the clinical blood use safety.