滤白机采血小板输注不良反应回顾性调查

Retrospective investigation on adverse reactions of leukocyte-filtrated platelets transfusion in a hospital

目的回顾性调查本院1个月内连续发放的483例滤白机采血小板引起的输血不良反应情况。方法通过电子病历系统回顾性调查2017年1—2月发放的滤白机采血小板输注情况,按照国际输血协会发布的《非感染性ATR监测标准》分别对每次输血不良事件进行输血相关性分级和诊断。结果 179名患者共计输血467次,输注滤白机采血小板483治疗量,经评估发生输血不良反应事件78次,与输血肯定相关的16例,很可能相关的30例,可能相关的32例,输血不良反应发生率为14.99%,不良反应发生以非溶血性发热性输血反应62例(13.3%)和过敏反应8例(1.7%)为主,输血相关性呼吸困难发生3例(0.6%),患者输血史和输血次数与不良反应发生相关(P<0.05)。结论血小板输血不良反应实际发生率高于临床回报率,反复输血患者发生不良反应情况增加,血小板输血引起的不良反应引起临床关注。

Objective To investigate the adverse reactions of leukocyte-filtrated platelets transfusion in 179 recipients within 1 month in our hospital. Methods The leukocyte-filtrated platelets transfusion issued from January to February 2017 was investigated retrospectively through the electronic medical record system. According to the Surveillance of Non-infectious Adverse Transfusion Reactions proposed by the ISBT in 2011, each transfusion-associated adverse event was classified and diagnosed. Results A total of 483 units of leukocyte-filtrated platelets were transfused in 179 patients with 467 times. And 78 adverse events were confirmed, with the incidence of adverse reactions of 14.99%;experts′ estimates classified apparently transfusionrelated adverse reaction in 16 cases, probable in 30 cases, possible in 32 cases. The main adverse reactions were non-hemolytic febrile transfusion reaction in 62 cases(13.3%), then allergic reaction in 8 cases(1.7%), and transfusion-associated dyspnea in 3 cases(0.6%). The history of blood transfusion and the times of blood transfusions were correlated with adverse reactions(P<0.05).Conclusion The actual incidence of platelet transfusion adverse reactions outweighs the return in clinical, which occurred more often in repeated transfusion patients. Platelet transfusion adverse reactions deserve serious clinical concern.