233例儿童非传染性输血不良反应相关因素分析

Analysis of related factors of non-infectious transfusion adverse reactions in 233 children

目的:通过对患儿输血不良反应回顾调查分析,了解患儿非传染性输血不良反应发生频率及类别,探讨降低和预防儿童输血不良反应的措施。方法:通过临床输血计算机管理系统和纸质回报单等统计2018年5月—2020年4月输血不良反应回报率变化情况,收集相关病历资料进行综合分析。结果:期间成分输血共40556例,总计64322袋,发生输血不良反应233例,其中过敏反应190例(81.55%),发热反应43例(18.45%)。各血液成分不良反应发生率差异有统计学意义(P<0.001),单采血小板输血不良反应发生率明显高于其他血液成分(P<0.001)。实施网上直报后,2019年5月—2020年4月较2018年5月—2019年4月输血不良反应回报率明显提升,输血不良反应回报率差异有统计学意义(P<0.001)。输血不良反应发生率与性别无关,1岁以上年龄组患儿输血不良反应发生率明显高于0~1岁组(P<0.001),有输血史患儿的不良反应发生率明显高于无输血史患儿(P<0.001)。结论:儿童输血不良反应发生率较高,临床医生应严格掌握输血指征,减少不必要输血,多部门共同配合,降低不良反应发生率,确保输血安全。

Objective:To investigate the frequency and category of non-infectious blood transfusion adverse reactions in children and discuss the measures to reduce and prevent adverse reactions of blood transfusion in children through retrospective investigation and analysis of adverse reactions of blood transfusion in children.Methods:The clinical transfusion computer management system and paper return form were used to analyze the changes of the rate of return on transfusion adverse reactions in our hospital from May 2018 to April 2020,and the relevant medical records were collected for comprehensive analysis.Results:In our hospital from May 2018 to April 2020,a total of 40556 patients(64322 bags in total)received component blood transfusions,among which 233 patients happened adverse reactions,including 190 allergic reactions(81.55%)and 43 febrile reactions(18.45%).There was significant difference in the rate of adverse reactions among all blood components(P<0.001),and the rate of adverse reactions in transfusion of monopheresis platelets was significantly higher than that of other blood components(P<0.001).After the implementation of online direct reporting,the rate of return on adverse reactions of blood transfusion from May 2019 to April 2020 was significantly higher than that from May 2018 to April 2019,and the difference of rate of return on adverse reactions of blood transfusion was statistically significant(P<0.001).The incidence of adverse reactions of blood transfusion was not related to gender.The incidence of adverse reactions of blood transfusion was significantly higher in children aged over 1 years than that in children aged 0-1 years(P<0.001),and the incidence of adverse reactions in children with a history of blood transfusion was significantly higher than that in children without a history of blood transfusion(P<0.001).Conclusion:The rate of adverse reactions of blood transfusion was high in children.Clinicians should strictly control the bood transfusion indication,reduce unnecessary blood transfusion,cooperate with multiple departments,reduce the incidence of adverse reactions,and ensure the safety of blood transfusion.