输血不良反应原因调查及输血检验的质量控制分析

Investigation of adverse reactions of blood transfusion and analysis of quality control of blood transfusion test

目的探讨输血不良反应的原因及分析输血检验的质量控制与输血安全,提出防范对策。方法随机抽取2014年4月~2019年3月反馈至我中心血站的发生输血不良反应患者150例,回顾性分析患者在临床输血时存在的风险因素并进行分析,记录输血患者科室分布情况及不同血制品发生输血不良反应情况,并分析发生输血不良反应情况的主要原因。结果输血患者科室分布情况比较,血液科有33例(22.0%),外科有40例(26.7%),肝病科有29例(19.3%),内科26例(17.3%),ICU 15例(10.0%),妇产科7例(4.7%)。其中血液科、外科所占比例较大。以病毒灭活冰冻血浆发生输血不良反应率最高,共54例(36.0%),所有患者中未见溶血性输血反应及其他不良反应发生。单因素分析显示:既往过敏史、输血次数、发血至输血间隔时间、原发性血液病为输血常见不良危险因素,差异均具有统计学意义(P<0.05)。结论严格控制血型实验室的输血检验质量,是临床输血安全的有效保障,全面的评估临床输血时出现的不良反应等风险因素,输血前制定并严格完成针对性的输血检验方案,排除输血时潜在的风险因素,必须做好交叉配血试验等,以提高输血的安全性,降低不良反应的发生率。

Objective To explore the causes of adverse reactions in blood transfusion,to analyze the quality control and safety of blood transfusion test,and to put forward countermeasures.Methods From April 2014 to March 2019,150 patients with adverse reactions of blood transfusion who were fed back to our central blood station were randomly selected.The risk factors of patients in clinical blood transfusion were analyzed retrospectively,and the distribution of blood transfusion departments and adverse reactions of different blood products were recorded,and the main causes of adverse reactions of blood transfusion were analyzed.Results There were 33 cases(22.0%)in hematology department,40 cases(26.7%)in surgery department,29 cases(19.3%)in hepatology department,26 cases(17.3%)in internal medicine department,15 cases(10.0%)in ICU and 7 cases(4.7%)in gynecology and obstetrics department.Hematology and surgery account for a large proportion.The highest rate of adverse reactions of transfusion occurred with virus inactivated frozen plasma,which was 54 cases(36.0%).No hemolytic transfusion reaction and other adverse reactions were found in all patients.Single factor analysis showed that the history of allergy,the number of blood transfusions,the interval between blood transfusions and blood transfusions,and the primary blood diseases were the common adverse risk factors of blood transfusions,and the differences were statistically significant(P<0.05).Conclusion It is an effective guarantee for clinical transfusion safety to strictly control the quality of transfusion test in blood type laboratory,comprehensively evaluate the risk factors such as adverse reactions during clinical transfusion,formulate and strictly complete the targeted transfusion test plan before transfusion,eliminate the potential risk factors during transfusion,and do well in cross matching test,so as to improve the safety of transfusion and reduce the adverse reactions Incidence rate.