胎儿贫血行宫内输血术时0.7~0.8 Hct浓缩洗涤红细胞制备技术开发与临床应用

Preparation and clinical application of 0.7~0.8 hematocrit concentrated washed red blood cells in intrauterine blood transfusion for fetal anemia

目的以胎儿贫血行宫内输血术需求为导向,开发0.7~0.8 Hct浓缩洗涤红细胞制备新技术,并应用于临床。方法取广州血液中心2020年3月~2021年2月保存期内红细胞悬液及冻存红细胞,制备成浓缩洗涤红细胞后,根据推导公式加入相应重量红细胞保存液,得到0.7~0.8 Hct浓缩洗涤红细胞,将其血常规检测数据进行单样本t检验统计分析,P<0.05为差异有统计学意义。将保存期内检验合格的Rh阴性、O型、0.7~0.8 Hct浓缩洗涤红细胞应用于临床宫内输血治疗。结果根据新技术制备的浓缩洗涤红细胞Hct可达0.7~0.8;红细胞计数[(8.389±0.808)×10^(12)/L]与血红蛋白含量[(233.730±15.498)g/L]均高于成人正常高值;白细胞计数[(0.732±0.469)×10^(9)/L]与Plt[(26.000±26.276)×10^(9)/L]均低于成人正常低值;平均红细胞体积[(88.123±6.359)fL]、平均红细胞血红蛋白含量[(30.004±2.809)pg]与平均红细胞血红蛋白浓度[(339.980±11.865)g/L]均与成人正常值无异;且应用该血液行宫内输血术后,胎儿贫血情况得到明显改善并预后良好。结论用新技术制备的0.7~0.8 Hct浓缩洗涤红细胞,与胎儿贫血行宫内输血术时,特殊的血源要求相契合,符合临床治疗规范,可推广应用。

Objective To develop a new approach for the preparation of 0.7~0.8 hematocrit concentrated washed red blood cells(RBCs)for fetal anemia in utero transfusion and apply it in clinical.Methods The erythrocyte suspension and frozen stored erythrocytes within expiry date in Guangzhou Blood Center from March 2020 to February 2021 were taken to prepare concentrated washed RBCs.According to the derivation formula,corresponding weight of RBC preservation solution was added to obtain 0.7~0.8 hematocrit concentrated washed RBCs.Routine blood test data were statistically analyzed by single-sample t test,and P<0.05 was considered statistically significant.Qualified Rh-negative/O-type 0.7~0.8 hematocrit concentrated RBCs within expiry date were used in clinical intrauterine blood transfusion.Results The hematocrit of concentrated washing RBCs prepared by the new approach could reach 0.7~0.8.The RBCs count(8.389±0.808)×10^(12)/L and hemoglobin content(233.730±15.498)g/L were higher while the erythrocyte count(0.732±0.469)×10^(9)/L and platelets count(26.000±26.276)×10^(9)/L were lower than the normal values of adults.The mean erythrocyte volume(fL),hemoglobin content(pg)and concentration(g/L)were 88.123±6.359,30.004±2.809 and 339.980±11.865,respectively,which were normal values of adults.Fetal anemia was significantly improved and the prognosis was good after intrauterine blood transfusion.Conclusion The 0.7~0.8 hematocrit concentrated washed RBCs prepared by the new approach is consistent with the special blood requirements during fetal anaemia transfusion,meets the clinical treatment standards,and can be applied in clinical.