精准电子交叉配血技术临床应用价值探讨

Research on clinical value of precision electronic cross matching

目的探讨精准配血技术在临床输血中应用价值。方法确认献血员血型结果且直抗和抗筛均阴性血液入库。首次输血、治疗中输血次数≥3 次 1 811 例患者用常规配血法直抗、抗筛均阴性的 359 例患者为常规配血组。首次输血、治疗中输血次数≥3 次 2 028 例患者用精准配血法直抗、抗筛均阴性 332 例患者为精准配血组。利用数据库进行献血员和患者自动匹配。各组均用血清学试验平行论证,追踪评价输血疗效。结果患者和献血员直抗阳性率分别为0. 49%和 0. 03%,抗筛阳性率分别为 0. 52%和 0. 06%。以血清学试验结果为标准常规配血总合格率达 99. 76%,但新生儿合格率仅为 42. 86%。多次重复输血后精准配血组抗体阳性率和不良反应发生率均明显低于常规配血组,差异有统计学意义( P < 0. 05)。结论精准交叉配血可以减少血液制品的浪费、减少患者输血不良反应。

Objective To explore the value of precision electronic cross matching ( PECM) technology in clinical blood transfu- sion. Methods The blood with confirmed type and negative direct resistance,anti-screening results were conducted for blood storage. Among the 2 028 patients who received ≥3 times blood transfusion in both the first transfusion and the treatment,332 patients with negative blood transfusion and anti-screening results were collected into the accurate matching group. The database was used for automatic matching between blood donors and patients. Each group was tested in parallel with serological tests to track the efficacy of transfusion. Results The positive rates of DAT of patients and blood donors were 0. 49% and 0. 03% respectively,and the positive rates of IAS were 0. 52% and 0. 06% respectively. According to the results of serology test,the total qualified rate of RECM was 99. 76%,but that of newborn was only 42. 86%. After repeated transfusions,the rate of antibody positive and incidence of adverse reactions in the PECM group was significantly lower than that in the RECM group, with the differences statistically significant ( P < 0. 05). Conclusion The cross blood transfusion technology from RECM to PECM not only reduces the waste of blood products,but also reduces the adverse reactions and risks of patients’blood transfusion.