ABO同型血交叉配血不合的影响因素及其处理对策

Influencing Factors of ABO Blood Cross-matching Incompatibility of the Same Type of Blood and Its Countermeasures

目的分析ABO同血型交叉配血不合的影响因素与处理对策。方法选取2018年12月至2019年12月入院治疗出现交叉配血不合的患者100例,运用微柱凝胶法实行交叉配血试验,对于配血不合的样本进行凝聚胺法与抗人球蛋白检测,根据患者的临床症状,进行血液的特异性及不规则抗体排查,分析引起ABO同血型交叉配血不合的影响因素,从而进行针对性的处理。结果通过试验数据可知,在本次研究的所有交叉配血不合的样本中,由自身携带抗体引发的有19例(19.00%),不规则性抗体引发的有34例(34.00%),凝聚素引发的有25例(25.00%),血浆蛋白发生异常引发的有7例(7.00%),溶血病影响的有11例(11.00%),药物引发的有4例(4.00%);此外,在交叉配血不合中,主侧不合的有69.00%,次侧不合的有17.00%,主次侧均不合的有13.00%。结论ABO血型鉴定及交叉配血的重要影响因素为冷凝集素、血型抗原抗体减弱以及血浆蛋白升高。自身携带的抗体、不规则性抗体、凝聚素等是引发ABO血型发生同血型交叉配血不合的主要影响因素。因此,在输血前,对血液进行交叉配血试验、不规则性抗体排查、冷凝集素试验、抗人球蛋白检测等,利于快速检测交叉配血是否相合,确保患者输血的有效性与安全性,有条件的医院能够将非急诊用血的患者的不完全抗体检测逐步纳入常规工作中,相比配血不合适再找到原因更加安全准确,对不具备条件做此项工作的医院可直接将存在高度怀疑的抗体直接送往上级医院进行救助,不规则抗体的有效筛查具有较高的临床价值。

Objective To analyze the influencing factors and Countermeasures of ABO and blood group cross matching incompatibility.Methods A total of 100 patients who had been admitted to hospital for treatment of incompatible cross matching between December 2018 to December 2019 hospitalized during cross matching and typing in patients 100 cases,by using micro column gel method implements the cross matching test,condensed the samples for matching and an amine method and anti globulin test,according to the patient's clinical symptoms,the specificity of the blood and irregular antibody screening,analysis the cause of ABO blood type with cross matching and not influence factors,and thus for the targeted treatment.Results Through the experimental data shows that in the study of all type and blood samples,triggered by itself with antibodies in 19 cases(19.00%),caused by irregular antibodies in 34 cases(34.00%),clusterin,cause there are 25 cases(25.00%),plasma protein anomalies caused by 7 cases(7.00%),the influence of hemolysis disease in 11 cases(11.00%),caused by drugs have 4 cases(4.00%).In addition,in cross-blood disagreement,69.00%of the primary side disagreement,17.00%of the secondary side disagreement,and 13.00%of the main and secondary sides.Conclusion The important influencing factors of patient ABO blood group identification and cross-blood matching were aggluttin,weakened blood type antigen antibody,and elevated plasma protein,Through the experiment shows that carry its own antibodies,irregularity,clusterin,happened cause ABO blood with blood type and main influence factors,therefore before a blood transfusion,blood on blood for type and crossmatch and irregular antibody screening,condensing set testing,anti globulin detection and so on,to quickly detect cross matching and consistency,and ensure the effectiveness and safety of the patients'blood transfusion,hospitals with conditions can gradually incorporate the incomplete antibody testing of patients with non-emergency blood into the routine work.It is more safe and accurate to find the reason than the blood matching is not appropriate.The hospitals that do not have the conditions to do this work can directly send the highly suspected antibodies to the superior hospital for assistance,Effective screening of irregular antibodies is of high clinical value.