输血前不规则抗体筛查结果分析

Analysis of Irregular Antibody Screening Results Before Blood Transfusion

目的分析输血前不规则抗体筛查结果。方法选取2018年1月-2021年3月南京市江宁中医院共6528例输血前进行不规则抗体筛查的患者作为研究对象,分析不规则抗体筛查在免疫溶血性输血反应中的预防效果。结果6528例输血前进行不规则抗体筛查的患者中不规则抗体筛查阳性70例,阳性率为1.07%;不同性别、妊娠史、输血史、肿瘤、血液疾病、消化道疾病间阳性率比较,差异有统计学意义(P<0.05)。70例不规则抗体筛查阳性中,Rh系统抗体阳性55例,占比78.57%;MMS系统抗体阳性9例,占比12.86%;Lewis系统抗体阳性6例,占比8.57%。经术前配血检测后,60例患者有相符合血型的血液输注,未发生免疫溶血性输血反应;8例患者未发现合适配血者,取消配血;2例发生溶血性贫血,均是由于自身抗体导致筛查结果为假阳性,输注洗涤红细胞,未出现输血不良反应。共发生4例免疫溶血性输血反应,发生率为0.06%。结论妊娠、多次输血、肿瘤疾病、血液疾病及消化道疾病是导致不规则抗体发生的重要因素,而输血前不规则抗体筛查对免疫溶血性输血具有良好的预防作用,有利于提高输血的安全性。

Objective To analyze the results of irregular antibody screening before blood transfusion.Methods A total of 6528 patients who underwent irregular antibody screening before blood transfusion in Jiangning Hospital of Traditional Chinese Medicine from January 2018 to March 2021 were selected as subjects.The preventive effect of irregular antibody screening in immune hemolytic transfusion reaction was analyzed.Results Among 6528 patients with irregular antibody screening before blood transfusion,70 cases were positive for irregular antibody screening,and the positive rate was 1.07%.There were statistically significant differences in the positive rates of gender,pregnancy history,blood transfusion history,tumor,blood disease and digestive tract disease(P<0.05).Among 70 cases of irregular antibody screening positive,55 cases were Rh system antibody positive,accounting for 78.57%;9 cases were MMS system antibody positive,accounting for 12.86%;6 cases were Lewis system antibody positive,accounting for 8.57%.After preoperative blood test,60 patients had blood transfusion consistent with blood type,and no immune hemolytic transfusion reaction occurred;8 patients did not find suitable blood,cancel the blood;2 cases of hemolytic anemia were due to autoantibodies leading to false positive screening results,transfusion of washed red blood cells,no adverse transfusion reactions.There were 4 cases of immune hemolytic transfusion reaction,the incidence was 0.06%.Conclusion Pregnancy,multiple blood transfusions,tumor diseases,blood diseases and digestive tract diseases are important factors leading to irregular antibodies,and irregular antibody screening before blood transfusion has a good preventive effect on immune hemolytic transfusion,which is beneficial to improve the safety of blood transfusion.