非感染性临床输血不良反应81例回顾性分析

Retrospective analysis of 81 cases of non-infectious clinical adverse transfusion reactions

目的探讨非感染性输血不良反应的发生情况及预防措施,从而提高医务人员对临床输血不良反应的认识和重视程度,降低输血不良反应发生率,建立安全、科学、合理的输血机制。方法回顾性分析济宁医学院附属滕州市中心人民医院2018年1月1日至2021年12月31日发生的81例输血不良反应,分析非感染性输血不良反应的科室分布、时间分布、年龄分布、血型及血制品种类分布等。统计学方法采用χ2检验。结果各种血液制品的输注过程中均可导致不同程度的输血不良反应。2018年1月1日至2021年12月31日期间接受输血的患者共24608人次,发生输血不良反应81例,总发生率为0.33%;发生科室主要集中在妇产科,年龄主要集中在20~<60岁,其中女性发生率为0.23%(56/24608),男性发生率为0.10%(25/24608);输血不良反应患者中有输血史54例(66.7%),无输血史27例(33.3%)。4年间2018年、2020年输血不良反应发生较多,共54例,占总数的66.7%;2019年和2021年较少,共27例,占总数的33.3%;不同年份之间输血不良反应发生率比较差异有统计学意义(χ2=9.528,P<0.05)。输注血液成分以去白细胞单采血小板的输血不良反应发生率最高[0.66%(22/24608)],其次为去白细胞悬浮红细胞[0.31%(43/24608)]、病毒灭活冰冻血浆[0.31%(16/24608)],其他血液制品未见输血不良反应发生,去白细胞单采血小板与去白细胞悬浮红细胞、病毒灭活冰冻血浆的输血不良反应发生率比较差异均有统计学意义(均P<0.05)。不良反应类型以过敏反应为最多,为58例,其次是非溶血性发热反应8例。结论临床输血作为救治危重症患者一项重要治疗措施,医护人员要严格按照规范和制度用血,尽最大努力地减少输血不良反应发生,使临床输血更安全、科学、合理。

Objective To investigate the occurrence and preventive measures of non-infectious adverse transfusion reactions,so as to improve the awareness and attention of medical staff on clinical adverse transfusion reactions,reduce the incidence of adverse transfusion reactions,and establish a safe,scientific,and reasonable transfusion mechanism.Methods A total of 81 cases of adverse transfusion reactions in Tengzhou Central People's Hospital Affiliated to Jining Medical College from January 1,2018 to December 31,2021 were retrospectively analyzed.The department distribution,time distribution,age distribution,blood type distribution,and blood product type distribution of non-infectious adverse transfusion reactions were analyzed.χ2 test was used for statistical analysis.Results The infusion process of various blood products could lead to different degrees of adverse transfusion reactions.A total of 24608 patient times received blood transfusion from January 1,2018 to December 31,2021,among them 81 cases of adverse transfusion reactions occurred,with a total incidence of 0.33%.The occurrence departments were mainly concentrated in department of gynecology and obstetrics,and the age was mainly concentrated in 21-<60 years old.The female incidence was 0.23%(56/24608),and the male incidence was 0.10%(25/24608).Among the cases of adverse transfusion reactions,54 cases had a history of blood transfusion,accounting for 66.7%,and 27 cases had no history of blood transfusion,accounting for 33.3%.In 2018 and 2020,there were 54 cases of adverse transfusion reactions,accounting for 66.7%of the total;in 2019 and 2021,there were 27 cases,accounting for 33.3%of the total;there was a statistically significant difference in the incidence of adverse transfusion reactions among different years(χ2=9.528,P<0.05).The incidence of adverse transfusion reactions was the highest in leukocyte-depleted apheresis platelets[0.66%(22/24608)],followed by leukocyte-depleted suspended red blood cells[0.31%(43/24608)]and virus-inactivated frozen plasma[0.31%(16/24608)],there were no adverse transfusion reactions in other blood products,and there was a statistically significant difference in the incidence of adverse transfusion reactions among leukocyte-depleted apheresis platelets,leukocyte-depleted suspended red blood cells,and virus-inactivated frozen plasma(P<0.05).The most common adverse reaction was allergic reaction(58 cases),followed by nonhemolytic fever(8 cases).Conclusion Clinical blood transfusion is an important treatment measure for critically ill patients,so medical staff should strictly abide by the relevant blood transfusion management procedures and technical operation norms and try our best to reduce adverse transfusion reactions,to make clinical blood transfusion safer,more scientific,and more reasonable.