适用于新生儿的输血前检验方法及输血策略研究

Research of pre-blood transfusion test and blood transfusion strategy for newborns

目的观察分析新生儿的输血前检验方法 ,并找出最理想输血检验方法 ,制定相关输血策略。方法 27例新生儿ABO溶血病患儿,取所有患儿血清标本,使用备用的同血型血样用微柱凝胶和凝聚胺技术实施交叉配血,观察患儿使用不同检验方式的血清不相合次数,分析直抗类和交叉配血的结果。结果患儿均通过三类检验、微柱凝胶技术、凝聚胺交叉配血,累计配血次数112次,其中应用微柱凝胶技术配比血清的不相合次数为74例,与散液中不相合次数为59次,凝聚胺技术配比血清不相合7次,配比散液不相合次数13次,微柱凝胶技术配比血清和散液中的不相合次数高于凝聚胺技术。凝聚胺技术实施血清交叉配血结果比较,差异无统计学意义(P>0.05);直抗阳性患儿血清及其放散液交叉配血不合率明显高于直抗阴性患儿,差异有统计学意义(P<0.05)。结论微柱凝胶技术是最适用于新生儿溶血病患儿输血前检验的方法 ,以检验结果选择与患儿相容性高或同血型血样进行输血。

Objective To observe and analyze pre-blood transfusion test measures for newborns,and tofind an ideal blood transfusion test way and establish related blood transfusion strategy.Methods Serum sampleswere taken from27newborns with ABO hemolytic disease of the newborn for cross-matching of blood by microcolumngel and polybrene technique through reserved samples of the same blood type.Observation was madeon serum in consistency times by different test ways to analyze outcomes of direct antiglobulin test and crossmatchingof blood.Results All newborns received three-type test,micro-column gel technique and polybrenecross-matching of blood for totally112times.Micro-column gel technique showed74non-consistency timesin its matched serum and59times in matched disperse liquid.Polybrene technique showed7non-consistencytimes in its matched serum and13times in matched disperse liquid.Micro-column gel technique had highernon-consistency times in its matched serum and matched disperse liquid than polybrene technique.There wasno statistically significant difference of cross-matching of blood outcomes in polybrene technique(P>0.05).Newborns with positive direct antiglobulin test outcome had obviously higher non-consistency rate between serumand disperse liquid than that in newborns with negative direct antiglobulin test outcome,and their difference hadstatistical significance(P<0.05).Conclusion Micro-column gel technique acts as the most suitable method forpre-blood transfusion test for HDN newborns,and test outcome can guide blood transfusion selection for highconsistency blood or same type blood.