主次侧交叉配血不合患者输血疗效分析

Blood transfusion efficacy in patients with major and minor cross-match incompatibility: analysis of 17 cases

目的回顾比较直接抗人球蛋白试验、间接抗人球蛋白试验、自身抗体同时阳性且无特异性抗体的主次侧交叉配血不合患者,输注ABO同型去白细胞悬浮红细胞或洗涤红细胞后的输血效果。方法检测患者输血前后血红蛋白及总胆红素,应用IBM SPSS Statistics 22.0软件进行统计分析。结果 17例主次侧交叉配血不合患者合计输血次数34次,输注ABO同型去白细胞悬浮红细胞或洗涤红细胞均使血红蛋白水平明显升高(P<0.001),均未使总胆红素水平上升(P>0.05),输血疗效无显著性差异(P>0.05)。输注每单位去白细胞悬浮红细胞与洗涤红细胞后,血红蛋白水平分别上升11.35±8.07和13.94±9.017 g/L,总胆红素分别下降25.76±88.63和6.91±9.39μmol/L。结论对于有明确输血需求的主次侧交叉配血不合患者,应及时给予红细胞输注,输注ABO同型去白细胞悬浮红细胞与洗涤红细胞治疗均有效。但洗涤红细胞制备时间长,保存时间短,建议优先输注ABO同型去白细胞悬浮红细胞。

Objective To compare the transfusion effects of ABO homotype leukocyte depleted suspended RBC and washed RBC in patients, who present major and minor cross-match incompatibility, DAT+,IAT+ and autoantibody+.Methods The hemoglobin and total bilirubin of patients before and after transfusion were detected, and statistical analysis was conducted by IBM SPSS Statistics 22.0 software. Results 34 transfusions were performed in 17 patients with major and minor cross-match incompatibility. Both leukocyte depleted suspended RBC and washed RBC significantly increased Hb level(P<0.001)but not TBIL level(P>0.05), with similar transfusion efficacy(P>0.05).After t, Hb levels(g/L) increased by 11.35±8.07 and 13.94±9.017, and TBIL(μmol/L) decreased by 25.76±88.63 and 6.91±9.39, respectively, after the transfusion of leukocyte depleted suspended RBC and washed RBC per unit. Conclusion For blood recipients with major and minor cross-match incompatibility, both ABO homotype leukocyte depleted suspended RBC and washed RBC,given in time, were effective. However, washed RBC is secondary choice due to long preparation time and short storage time.