输血前不规则抗体筛查在预防红细胞输注无效中的应用价值

Application value of irregular antibody screening before blood transfusion in prevention of invalid red blood cell transfusion

目的分析输血前不规则抗体筛查在预防红细胞输注无效中的应用价值。方法选取我院2017年9月至2018年9月需要输血但未接受输血前不规则抗体筛查的800例患者设为对照组,另选取我院2018年10月至2019年10月需要输血且已经接受输血前不规则抗体筛查的800例患者设为研究组。其中研究组患者使用微柱凝胶法实施不规则抗体筛查,对所有阳性结果进行抗体鉴定。对比分析两组患者输血后的红细胞输注无效发生情况。结果实验室检查结果显示,800例研究组患者中不规则抗体阳性者13例,阳性检出率为1.63%。女性患者抗体阳性检出率高于男性,1年输血次数≥3次患者抗体阳性检出率高于1年输血次数<3次患者,有输血禁忌患者阳性检出率高于无输血禁忌患者,差异具有统计学意义(P<0.05)。不同年龄、有无消化道疾病、肿瘤疾病、骨折等外伤性疾病患者抗体阳性检出率比较,差异无统计学意义(P>0.05)。研究组的红细胞输注无效发生率为0.25%(2/800),明显低于对照组的2.00%(16/800),差异具有统计学意义(P<0.05)。Rh血型系统抗体阳性9例(69.23%),MNS血型系统抗体阳性2例(15.38%),Lewis血型系统抗体阳性2例(15.38%)。结论对需要输血患者进行输血前不规则抗体筛查,一方面可保障不规则抗体阳性患者输血的安全性,另一方面可有效预防红细胞输注无效,避免溶血性输血反应的发生。

Objective To analyze the application value of irregular antibody screening before blood transfusion in prevention of invalid red blood cell transfusion. Methods A total of 800 patients in our hospital who needed blood transfusion but did not receive irregular antibody screening before blood transfusion from September 2017 to September2018 were selected as control group, and 800 patients in our hospital who needed blood transfusion and had received irregular antibody screening before blood transfusion from October 2018 to October 2019 were selected as study group. The patients in the study group were screened for irregular antibody by microcolumn gel method, and all positive results were identified. The occurrence of invalid red blood cell transfusion after blood transfusion was compared between the two groups. Results Laboratory test results showed that there were 13 cases of irregular antibody positive in 800 patients in the study group, and the positive detection rate was 1.63%. The positive detection rate of antibody in female patients was higher than that in male patients, the positive detection rate of antibody in patients with blood transfusion times ≥3 within1 year was higher than that in patients with blood transfusion times <3 within 1 year, the positive detection rate of antibody in patients with blood transfusion taboo was higher than that in patients without blood transfusion taboo, and the differences were statistically significant(P <0.05). There were no significant differences in the positive detection rate of antibody in patients with different age, digestive tract diseases, tumor diseases, fractures and other traumatic diseases(P>0.05). The incidence of invalid red blood cell transfusion in the study group was 0.25%(2/800), which was significantly lower than2.00%(16/800) in the control group, and the difference was statistically significant(P<0.05). There were 9 cases(69.23%)with Rh blood group system antibody positive, 2 cases(15.38%) with MNS blood group system antibody positive and 2 cases(15.38%) with Lewis blood group system antibody positive. Conclusion Irregular antibody screening before blood transfusion for patients who need blood transfusion can ensure the safety of blood transfusion for patients with irregular antibody positive, and on the other hand, it can effectively prevent invalid red blood cell transfusion and avoid hemolytic transfusion reactions.