待输血患者不规则抗体筛查对输血安全的意义

Significance of irregular antibody screening for blood transfusion candidates

目的探讨待输血患者不规则抗体筛查对输血安全的意义。方法选取2018年1月至2019年1月南阳市第二人民医院收治的待输血患者2400例,采用微注凝胶技术进行不规则抗体筛查。统计不规则抗体阳性率,特异鉴定结果,分析阳性患者在性别、输血史、妊娠史中的分布情况以及输血治疗情况。结果2400例行不规则抗体筛查预输血患者中,共筛查出不规则抗体阳性16例,阳性率为0.67%。16例不规则抗体阳性患者中,12例为Rh血型,其中抗E型6例,抗Cc型2例,抗cE型3例,抗D型1例;MNS血型4例,均为抗M型;阳性不规则抗体患者在性别、有无输血史、有无妊娠史中的分布比较差异有统计学意义(P<0.05)。16例阳性患者中,11例采取手术延期处理,在术前经筛选配血得到血型匹配血液,手术进展顺利,无输血不良事件发生;2例阳性患者为妊娠期妇女,根据患者特异鉴定结果,选择交叉配血试验结果为相合的红细胞悬液给予输血治疗,无输血不良事件发生;1例为溶血性贫血患者,结果为假阳性,输注洗涤红细胞后无不良反应;另2例患者未找到匹配血型,放弃输血治疗。结论对预输血患者进行不规则抗体筛查,能有效降低输血不良反应,有助于临床为患者选择匹配血液,确保输血安全。

Objective To investigate the significance of irregular antibody screening for blood transfusion candidates.Methods A total of 2400 patients requiring blood transfusion in Nanyang Second People’s Hospital from January 2018 to January 2019 were enrolled in the study.Microinjection gel technology was used to screen irregular antibodies.The positive rate of irregular antibody and specific identification results were calculated.The distributions of positive irregular antibody in patients with different genders,blood transfusion histories and pregnancy histories were statistically analyzed.Then the transfusion therapy efficacy was analyzed.Results Among 2400 blood transfusion candidates,16 cases were irregular antibody positive,with a positive rate of 0.67%.Among the 16 patients with irregular antibody positive,12 cases were Rh blood type,including 6 cases of E type,2 cases of anti-Cc type,3 cases of anti-cE type,1 case of anti-D type;4 of 16 cases were MNS blood type,and all of them were anti-M type;there were significant differences in the distribution of irregular antibody positive patients in gender,blood transfusion history and pregnancy history(P<0.05).Among the 16 patients with irregular antibody positive,11 patients delayed operation until had matched blood according to preoperative screening,and the operations were successful,without any adverse reaction of transfusion.Two cases of irregular antibody positive patients were pregnant women;according to the specific identification results,washing red blood cell suspension with compatibly matched results in cross matching tests was transfused into them;and no adverse reactions of transfusion occurred.One patient had hemolytic anemia,of which the screening result was false positive due to autoantibodies;and no adverse reactions occurred after transfusion of washed red blood cells.The other 2 patients did not receive blood transfusion because of no matching blood type.Conclusions Irregular antibody screening for patients who are going to have blood transfusion can effectively reduce the incidence of adverse reactions of blood transfusion,which has high clinical value in matched blood selection and can ensure the safety of blood transfusion.