云南省地中海贫血儿童输血安全策略的研究

The Transfusion Management in Children with Thalassemia:Safety Strategies in Yunnan Province

目的制定云南省地中海贫血儿童输血安全策略,探讨策略的可行性和安全性。方法选取策略实施前(2012年~2016年)、后(2017年~2021年)云南省地中海贫血高发的8个地州市接受一次及以上输血治疗的地中海贫血儿童2620例,比较输血安全策略实施前、后意外抗体阳性检出率和输血不良反应发生率。结果策略实施后,意外抗体阳性检出率和输血不良反应发生率明显降低,意外抗体阳性检出率从33.62%降至7.64%,输血不良反应发生率从4.31%降至0.36%,差异有统计学意义(P<0.01)。结论云南省地中海贫血儿童输血安全策略科学、合理、有效,应对地中海贫血儿童常规进行ABO、RhCcDEe和MNSs血型抗原检测和意外抗体筛查,可预防性输注与患儿ABO、RhCcDEe和MNSs抗原分型一致的血液,确保输血治疗安全有效。

Objective To explore the safe blood transfusion strategy for thalassemia in children in Yunnan Province.Methods A total of 2620 children diagnosed with thalassemia who received once or repeated blood transfusions in eight cities with a high incidence of thalassemia in Yunnan Province before(from 2012 to 2016)and after(from 2017 to 2021)the implementation of the safe blood transfusion strategy were selected.The positive rate of screening antibodies and the incidence of adverse reactions in blood transfusion were compared.Results After the implementation of the strategy,the positive rate of screening antibodies and the incidence of adverse reactions in blood transfusion were significantly reduced.The positive rate of screening antibodies decreased from 33.62%to 7.64%,and the incidence of adverse reactions in blood transfusion decreased from 4.31%to 0.36%,and the differences were statistically significant(P<0.01).Conclusion The safe transfusion strategy is scientific,reasonable and effective.The detection of ABO,Rh-CcDEe and MNSs blood group antigen and screening antibodies should be performed in practice in children with thalassemia.Prophylactic ABO,Rh-CcDEe and MNSs antigen-matched blood is transfused to ensure the safety and effectiveness of transfusion therapy.