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输血不良反应相关影响因素分析

Analysis of related influencing factors of adverse reactions of blood transfusion
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摘要 目的分析临床输血不良反应发生情况及其分布特点,并探讨相关影响因素,为降低输血不良反应发生率和保障临床输血安全提供参考依据。方法回顾性分析2019-2022年在福建医科大学附属福清市医院接受输血治疗的6890例患者的临床病历资料。分析产生输血不良反应的原因,并对数据进行分类与统计。比较不同血液成分、性别、年龄、血型、输血史、血液制品是否去除白细胞,以及血小板和红细胞储存时间对输血不良反应的影响,记录输血不良反应发生的主要科室和疾病分布情况。结果2019-2022年共输血19180人次,发生输血不良反应71人次。2019-2022年各年度输血不良反应发生率分别为0.16%、0.42%、0.41%、0.47%,各年度不良反应发生率比较,差异无统计学意义(χ^(2)=7.03,P>0.05)。不良反应类型以过敏反应和非溶血性发热反应为主,并且过敏反应发生率呈逐年上升趋势。2019-2022年红细胞输血不良反应发生率为0.28%,血浆为0.38%,血小板为1.32%,冷沉淀为0.45%,各种血液成分之间输血不良反应发生率比较,差异有统计学意义(χ^(2)=32.80,P<0.05)。红细胞主要以非溶血性发热反应为主,血浆、血小板和冷沉淀均以过敏反应为主。男性与女性受血者输血不良反应发生率比较,差异无统计学意义(χ^(2)=0.25,P>0.05);不同年龄受血者输血不良反应发生率比较,差异无统计学意义(χ^(2)=1.36,P>0.05);不同ABO血型患者输血不良反应发生率比较,差异无统计学意义(χ^(2)=1.87,P>0.05);有输血史的受血者输血不良反应发生率高于无输血史受血者,差异有统计学意义(χ^(2)=11.43,P<0.05);受血者输注去除白细胞的血液制品输血不良反应发生率低于输注未去除白细胞的血液制品,差异有统计学意义(χ^(2)=5.38,P<0.05)。发生输血不良反应前5名的科室分别为血液科、消化内科、妇科、重症监护病房和感染科。随着血小板储存时间增加,输血不良反应发生率呈逐渐上升趋势,差异有统计学意义(χ^(2)=32.61,P<0.05)。随着红细胞储存时间增加,输血不良反应发生率呈先上升再逐渐下降趋势,但差异无统计学意义(χ^(2)=4.04,P>0.05)。结论福建医科大学附属福清市医院输血不良反应以非溶血性发热反应和过敏反应为主。发生输血不良反应的主要原因与血液成分、输血史、血液制品是否去除白细胞及血小板储存时间有关。临床应多因素管理输血患者,以降低其输血不良反应的发生率。 Objective To analyze the incidence and distribution characteristics of adverse blood transfusion reactions,explore the related influencing factors,and provide reference for reducing the incidence of adverse blood transfusion reactions and ensuring the safety of clinical blood transfusion.Methods The clinical data of 6890 patients who received blood transfusion in Fuqing City Hospital Affiliated to Fujian Medical University from 2019 to 2022 were retrospectively analyzed.The causes of adverse reactions of transfusion were analyzed,and the data were classified and statistically analyzed.The effects of different blood components,gender,age,blood type,transfusion history,whether white blood cells were removed from blood products,and storage time of platelets and red blood cells on adverse transfusion reactions were compared.The main departments and disease distribution of adverse transfusion reactions were recorded.Results From 2019 to 2022,a total of 19180 patients received blood transfusion,and 71 patients had adverse blood transfusion reactions.The incidence of adverse blood transfusion reactions in each year from 2019 to 2022 was 0.16%,0.42%,0.41%and 0.47%respectively.There was no significant difference in the incidence of adverse reactions between years(χ^(2)=7.03,P>0.05).The main types of adverse reactions were allergic reactions and non-hemolytic fever reactions,and the incidence of allergic reactions was increasing year by year.From 2019 to 2022,the incidence of adverse reactions of red blood cell transfusion was 0.28%,that of plasma was 0.38%,that of platelet was 1.32%,and that of cryoprecipitate was 0.45%.There was a statistically significant difference in the incidence of adverse transfusion reactions among various blood components(χ^(2)=32.80,P<0.05).Red blood cells showed a non-hemolytic febrile reaction,while plasma,platelets and cryoprecipitate showed an allergic reaction.There was no significant difference in the incidence of adverse transfusion reactions between male and female recipients(χ^(2)=0.25,P>0.05).There was no significant difference in the incidence of adverse reactions of blood transfusion among recipients of different ages(χ^(2)=1.36,P>0.05).There was no statistically significant difference in the incidence of adverse transfusion reactions among patients with different ABO blood groups(χ^(2)=1.87,P>0.05).The incidence of adverse reactions of blood transfusion in recipients with transfusion history was higher than that in recipients without transfusion history,and the difference was statistically significant(χ^(2)=11.43,P<0.05).The incidence of adverse reactions of blood transfusion in recipients with leukocyte removed blood products was lower than that of blood products without leukocyte removed,and the difference was statistically significant(χ^(2)=5.38,P<0.05).The top 5 departments with adverse transfusion reactions were hematology department,gastroenterology department,gynecology department,ICU and infectious department.With the increase of platelet storage time,the incidence of adverse reactions of blood transfusion increased gradually,and the difference was statistically significant(χ^(2)=32.61,P<0.05).With the increase of red blood cell storage time,the incidence of adverse reactions of blood transfusion increased first and then gradually decreased,but the difference was not statistically significant(χ^(2)=4.04,P>0.05).Conclusion The main adverse reactions of blood transfusion in Fuqing City Hospital Affiliated to Fujian Medical University were non-hemolytic fever and allergic reactions.The main causes of transfusion adverse reactions are related to blood components,transfusion history,leukocyte removal of blood products,and storage time of platelets.Multiple factors should be managed to reduce the incidence of adverse reactions of blood transfusion.
作者 俞霞 马淑群 施明秀 林芷彤 翁雅云 徐永君 YU Xia;MA Shuqun;SHI Mingxiu;LIN Zhitong;WENG Yayun;XU Yongjun(Department of Blood Transfusion,Fuqing City Hospital Affiliated to Fujian Medical University,Fuzhou,Fujian 350300,China;Laboratory of Basic Medicine,900th Hospital of Joint Logistics Support Force,Fuzhou,Fujian 350025,China;Laboratory of Basic Medicine,Fuzhou General Clinical College of Fujian Medical University,Fuzhou,Fujian 350025,China)
出处 《检验医学与临床》 CAS 2024年第15期2254-2259,共6页 Laboratory Medicine and Clinic
基金 福建省科技创新联合资金项目(2019Y9042)。
关键词 血液安全监测 输血不良反应 过敏反应 非溶血性发热反应 储存损伤 haemovigilance adverse reactions of blood transfusion allergic reaction non-hemolytic febrile reaction storage lesion
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