不规则抗体筛查阳性患者输血治疗对策分析

Analysis of therapeutic countermeasures for blood transfusion in patients with positive screening for irregular antibodies

目的分析不规则抗体筛查阳性患者,运用盲筛配血和抗体鉴定后行筛选性配血两种配血方式的输血效果、不良反应发生率、配血所用时间,探讨两种配血方式的临床适用性。方法选取2014年1月—2023年11月于医院进行交叉配血的全部患者,统计不规则抗体筛查试验阳性患者并回溯其交叉配血方式,比较两种配血方式的输血效果、不良反应发生率及配血所用时间。结果选取55853例交叉配血患者中,不规则抗体筛查试验阳性患者共297例,阳性率为0.53%,其中266例患者采用盲筛进行交叉配血,154例患者输血,1例发生输血不良反应;31例患者采用抗体鉴定、经典抗人球蛋白法进行交叉配血,23例输血,无不良反应发生。盲筛配血所用时间为(35.98±3.43)min,筛选性配血所用时间为(321.60±75.77)min。结论不规则抗体筛查阳性患者交叉配血盲筛可节约配血时间、经济成本,对抢救危重患者有重要意义,但盲筛有风险,在条件允许情况下应尽可能进行抗体鉴定、经典抗人球蛋白行相合性输注以最大程度确保输血安全。

Objective To analyze the effectiveness of transfusions,adverse reaction rate and the time needed to match blood in the patients who tested positive in irregular antibody screening employing both blind screening and antibody identification blood matching procedures,and explore the clinical benefits of these two blood matching methods.Methods All patients used the cross-matching methods in our hospital from January 2014 to November 2023 were retrospectively analyzed,specifically focusing on those with positive irregular antibody screening tests.The goal was to compare the efficacy of two methods in terms of transfusion effectiveness,adverse reaction rate and time required for blood matching.Results Among 55853 patients for cross-matching,297 cases returned positive results for irregular antibody screening test,with a positive rate of 0.53%.266 patients were cross-matched by blind screening,154 patients were transfused,and 1 case had an adverse reaction to blood transfusion;31 patients were cross-matched by antibody identification and classical anti-human globulin method,and 23 cases were transfused and no adverse reactions occurred.The time used for blind screening was(35.98±3.43)min,and the time used for blood matching after antibody identification was(321.60±75.77)min.Conclusion Blind screening for cross-matching of patients with irregular positive antibody screening can save time and economic cost of blood matching,which is important for rescuing critically ill patients;however,there are risks associated with blind screening,and antibody identification and classical anti-human globulin line compatibility should be carried out as far as possible when the condition permits to ensure the maximum degree of transfusion safety.