肠梗阻、脓毒血症、多器官衰竭伴红细胞T多凝集1例

A case report of intestinal obstruction,sepsis,multiple organ failure with red blood cell T-polyagglutination

研究红细胞T多凝集现象的发现方式,探讨T多凝集患者的T-活化与输血、溶血的关系。通过对1例患儿临床资料调查及血型血清学检测的分析(血型鉴定、直接抗人球蛋白实验、不规则抗体筛查、交叉配血及与不同血清学的反应格局),确认为T多凝集。对诊疗经过追踪了解患儿T-活化与输血、溶血的关系。患儿为肠道感染引起红细胞T多凝集,输入血浆制品导致溶血反应,给予对症治疗,洗涤红细胞输注、手术、床旁血液净化后,患儿病愈出院。血型鉴定和交叉配血困难时要考虑多凝集情况的存在;T多凝集发生时多伴有溶血,输血应限制血浆成分输入。

To study the way to discover the phenomenon of T-polyagglutination in red blood cells,and to explore the relationship between T-activation and blood transfusion and hemolysis in patients with T-polyagglutination.Blood samples from a child with cross-matching secondary agglutination were sent to our laboratory.It identified as intestinal infection with red blood cells T-polyagglutination by analyzing the clinical data of investigation and serological detection of blood type.Hemolysis reaction was caused by the transfusion of plasma products,and symptomatic treatment was given.After washing red blood cell infusion,surgery,and blood purification by the bedside,the child recovered and was discharged from hospital.It is suggested that the existence of polyagglutination should be considered in blood group identification and cross-matching difficulties.The occurrence of T-polyagglutination is usually accompanied by hemolysis,so the input of plasma components should be limited for blood transfusion.