输血患者输血前感染性指标检测的结果分析与意义

Analysis and significance of the result of serum infection indicato rs in patients before transfusion

目的对输血前患者进行感染性指标的检测和分析,了解感染性指标检测对患者感染情况的影响,为控制医院感染,减少医疗纠纷提供重要依据.方法选取2013年1月至2017年12月本院4844例输血患者,采用化学发光法进行乙型肝炎病毒表面抗原(HBsAg)、丙型肝炎病毒抗体(抗-HCV)、人类免疫缺陷病毒抗体(抗-HIV)及苍白密螺旋体(抗-TP)的检测,数据采用SPSS 20.0软件进行分析.结果 4844例患者中有972例感染阳性,其中HBsAg阳性率最高为13.46%;随年份输血患者HBsAg和抗-HCV的阳性率呈下降趋势,比较差异有统计学意义(P<0.05);男性输血患者HBsAg和抗-HIV和总体阳性率显著同于女性输血患者(P<0.05);内科BsAg阳性率显著高于医院总阳性率(P<0.05);输血感染性指标阳性患者在各个年龄段均有分布,其中40~69岁人群占多数,占总数的80%以上;共有6种输血前交叉感染模式,其中溶血性黄杆菌(sg)+TP交叉感染模式最多有17例,占34%,sg+HCV交叉感染模式有16例,占32%.结论对输血患者进行感染性指标的检测,有助于感染患者的早期诊治,对减少医院感染,预防医疗纠纷,降低医务人员职业暴露有重要意义.

Objective To detect and analyze the serum infection indicators of patients before transfusion,and to understand the influence of serum infection indicator detection on patients' infection status,and provide an important basis for controlling hospital infection and reducing medical disputes. Methods A total of 4 844 transfusion patients from January 2013 to December 2017 were selected in this study. Hepatitis B virus surface antigen(HBsAg),hepatitis C virus antibody(anti-HCV),and human immunodeficiency virus antibody(anti-HIV)and Treponema pallidum(anti-TP)were detected by chemiluminescence method. The data were analyzed by SPSS 20.0. Results Totally 972 positive cases of related infection indicators were detected in 4 844 patients,and the highest was HBsAg,accounting for 13.46%. The positive rate of HBsAg and anti-HCV in blood transfusion patients showed a downward trend year by year,which was statistically significant (P<0.05). The positive rates of HBsAg and anti-HIV and the total positive rates in males were significantly higher than those of females(P<0.05). The positive rate of HBsA g was significantly higher than total positive rates in Internal Medicine Department (P<0.05). Positive transfusion infectious index patients were distributed in all age groups,including 40 to 69 years old,accounting for more than 80% of the total. We had six cross-infection patterns, during which there were 17(34%)patients with sg plus TP pattern of superinfection and 16(32%)cases of sg plus HCV pattern of superinfection before transfusion. Conclusion The detection of infectious indicators in transfusion patients can help early diagnosis and treatment of infected patients,and it is of great significance to reduce nosocomial infections, prevent medical disputes,and reduce occupational exposure of medical staff.