173例输血不良反应相关影响因素分析

Analysis on related influencing factors in 173 cases of adverse blood transfusion reactions

目的分析临床受血者发生输血不良反应的影响因素,为科学、安全用血提供依据。方法选择2014年1月至2020年3月于该院输血治疗的患者共44860例,分析受血者发生输血不良反应与年龄、性别、血型、输血史、过敏史、科室、输注的血液成分等的关系。结果44860例受血者中173例发生输血不良反应,输血不良反应总发生率为0.39%,其中过敏反应发生率为0.26%,非溶血性发热性输血反应为0.08%。单采血小板的输血不良反应发生率最高(0.58%),冷沉淀最低(0.05%),差异有统计学意义(P<0.05)。该院输血不良反应发生率最高的前3个科室为泌尿外科、神经外科、肝胆外科。不同年龄、有无输血史、有无过敏史、输注不同血液成分患者的输血不良反应发生率差异均有统计学意义(P<0.05),不同性别、血型的患者输血不良反应发生率比较,差异无统计学意义(P>0.05)。结论严格掌握输血适应证,采取预防措施,个性化输注血制品,加强各个环节的质量管理监督,是减少输血不良反应、安全合理用血的关键。

Objective To analyze the influencing factors of blood transfusion adverse reactions occurrence in clinical blood recipients in order to provide a basis for scientific and safe use of blood.Methods A total of 44860 patients with blood transfusion therapy in this hospital from January 2014 to March 2020 were selected.The relationship between the adverse reactions occurrence of blood transfusion with the age,sex,blood type,history of blood transfusion,history of allergy,department and blood composition of transfusion in blood recipients were analyzed.Results Among 44860 blood recipients,173 cases had adverse transfusion reactions,the total incidence rate of blood transfusion adverse reactions was 0.39%,in which the incidence rate of allergic reactions was 0.26%and which of non-hemolytic fever blood transfusion reactions was 0.08%.The incidence rate of transfusion reaction of apheresis platelets was the highest(0.58%)and that of cryoprecipitation was the lowest(0.05%),and the difference was statistically significant(P<0.05).The top three departments of the highest incidence of blood transfusion adverse reaction in this hospital were urological surgery,neurosurgery and hepatobiliary surgery.There were statistically significant differences in the transfusion reaction occurrence rate among the patients with different ages(P<0.05),history of blood transfusion(P<0.05),history of allergy(P<0.05)and transfusion of different blood components(P<0.05).There was no statistically significant difference in the transfusion reaction occurrence rate among the patients with different genders and blood types(P>0.05).Conclusion Strictly grasping the indications for blood transfusion,taking the preventive measures,individualized transfusion of blood products,and strengthening the quality management and supervision of each link are the key to reduce the adverse reactions of blood transfusion and use blood safely and rationally.