成分血献血者献血前筛查不合格主要原因分析

An Analysis of Major Reasons for the Failure of Pre Donor Screening for Blood Component Donors

目的分析成分血献血者献血前筛查项目不合格主要原因,以制定策略降低献血者献血前筛查不合格率。方法回顾性分析2018年11月26日至2019年8月26日4679例成分血献血者的献血前筛查结果。结果2018年11月26日至2019年8月26日期间成分血献血者献血前筛查总不合格率为21.29%,其中因WBC计数、PLT计数、ALT、Hb/HCT、乳糜、其他原因(健康征询、查体、病毒快速检定等)导致不合格的人数构成比分别为19.28%、6.93%、6.02%、56.62%、6.83%、4.32%,其中以Hb/HCT不合格者占比最多。将献血前筛查项目中因WBC计数、PLT计数、ALT、乳糜、其他原因不合格的献血者排除,对Hb/HCT合格与不合格献血者进行分组并分析两组人群的MCV、MCH、MCHC、RDW-CV,发现Hb/HCT不合格献血者群体的红细胞参数符合缺铁性贫血的血液学特征。结论成分血献血者中因Hb/HCT不合格导致献血前筛查被淘汰的比例较大,对于献血前筛查贫血的这部分成分血献血者,采供血机构应当积极关注其铁代谢指标,必要时给予其铁营养支持或补铁指导,在维护献血者健康的同时提升献血前筛查合格率。

Objective To analyze the major reason of failure of pre donor screening for blood component donors and develop corresponding strategies to reduce the failure rate of pre donor screening.Methods The results of pre donor screening of 4679 blood component donors from November 26,2018 to August 26,2019 were analyzed retrospectively.Results The total failure rate of pre donor screening for blood component donors during this period of time was 21.29%.In all the failures,the proportion of people who failed due to WBC count,PLT count,ALT,Hb/HCT,chyle,and other reasons(health consultation,physical examination,rapid virus verification test,etc.)were 19.28%,6.93%,6.02%,56.62%,6.83%,and 4.32%,respectively,among which Hb/HCT accounted for the most.Excluding blood donors who failed with WBC,PLT,ALT,chyle,and other reasons in pre donor screening,we divided the rest blood donors into Hb/HCT qualified and Hb/HCT unqualified groups,and analyzed MCV,MCH,MCHC,and RDW-CV for these two groups,and founded that the red blood cell parameters in the Hb/HCT unqualified group were consistent with the hematological characteristics of iron deficiency anemia.Conclusion Among blood component donors,a large proportion of them are eliminated during pre blood screening due to Hb/HCT un-qualification.For those blood donors who are found to be anemia before the blood donation,blood transfusion services should actively pay attention to their iron metabolism indicators,and if necessary,provide them with iron nutrition support or iron supplementation guidance,in order to improve the qualification rate of pre donor screening while maintaining the health of blood donors.