血液病患者ABO疑难血型的鉴定及输血策略

Identification of ABO Difficult Blood Types and Blood Transfusion Strategies in Patients with Hematological Diseases

目的对血液病患者的ABO疑难血型进行鉴定,并探讨其输血策略,以保证临床输血安全。方法查阅3例出现疑难血型的血液病患者的病历资料,针对性地进行抗-H试验、抗人球蛋白试验、唾液试验等血型血清学试验,确认患者的血型并分析其输血策略。结果患者1为多发性骨髓瘤患者,血型为B型Rh(D)阳性,选择B型Rh(D)阳性悬浮红细胞输注。患者2疑为白血病所致的血型减弱,血型为A弱Rh(D)阳性,建议病情好转后复查血型;选择O型Rh(D)阳性洗涤红细胞、A型Rh(D)阳性血小板输注。患者3为干细胞移植术后(B供O),血型为B弱Rh(D)阳性;选择O型Rh(D)阳性悬浮红细胞、B型Rh(D)阳性血小板输注。结论鉴定血液病患者的疑难血型应结合其疾病状态,查阅病历资料,分析干扰因素,设计针对性试验进行验证。

Objective ABO difficult blood types of patients with blood diseases were identified,and blood transfusion strategies were investigated to ensure the safety of clinical blood transfusion.Methods With review of medical records of 3 hematological patients with difficult blood types,serological tests such as anti-H test,antiglobulin test and saliva test were targetedly carried out.In addition,the patients'blood types were confirmed and their blood transfusion strategies were analyzed.Results With Patient 1 diagnosed with multiple myeloma,whose blood type is Rh(D)positive,the infusion mode of type B Rh(D)positive suspended red blood cells was selected;With patients 2 suspected of having weakened blood type due to leukemia,the blood type was A weak Rh(D)positive.It was recommended to recheck the blood type after the condition improves.Type O Rh(D)positive was selected to wash red blood cells,and type A Rh(D)positive platelets for transfusion;With patient 3 after stem cell transplantation,the blood type was B weak Rh(D)positive.Type O Rh(D)positive was selected for suspending red blood cells,and type B Rh(D)positive for platelet transfusion.Conclusion With the identification of difficult blood types of patients with blood diseases,the disease status of patients should be combined,case data should be consulted,interference factors should be analyzed,and targeted tests should be designed for verification.