2022年柳州市工人医院急诊科患者交叉配血不合原因分析及输血策略探讨

Analysis of the Causes of Cross Matching Incompatibility among Patients in the Emergency Department of Liuzhou Workers'Hospital in 2022 Year and Exploration of Blood Transfusion Strategies

目的调查分析2022年柳州市工人医院急诊科患者交叉配血不合原因,并提出相关输血策略,以保障输血的安全性。方法选择2022年1月—2022年12月在柳州市工人医院急诊科就医的3211例患者作为研究对象,在输血前均给予盐水法交叉配血,观察交叉配血不合发生情况并进行原因分析,提出交叉配血不合发生后的输血策略并观察输血结果。结果在3211例急诊患者中,发生交叉配血不合28例(研究组,其他患者归为对照组),占比0.87%,判断原因为自身免疫抗体10例、不规则抗体8例、ABO血型不合6例、冷抗体2例、样本污染2例。在28例交叉配血不合的患者中,采用输血策略包括在次侧寻找低于抗人球蛋白实验凝集强度的血液、再次配血、重新选择供者血液、选择正确的标本配血等,输血结果都为主侧相合与次侧相合。结论2022年柳州市工人医院急诊科患者交叉配血不合的发生率依然比较高,主要原因包括自身免疫抗体、不规则抗体、ABO血型不合等,积极选用正确方法再次配血、重新选择供者血液等输血策略可避免交叉配血不合情况的再次发生。

Objective To investigate and analysis the reasons for cross matching incompatibility among patients in the emergency department of Liuzhou Workers'Hospital in 2022 year,and propose relevant blood transfusion strategies to ensure the safety of blood transfusion.Methods From January 2022 to December 2022,3211 cases of patients who underwent emergency treatment in the emergency department of certain hospital were selected as the research subjects.Cross matching were provided before blood transfusion,and were to observe the occurrence of cross matching incompatibility and analyzed the reasons.Blood transfusion strategies and results were proposed after the occurrence of cross matching incompatibility.Results In the 3211 emergency patients,there were 28 cases(study group,others classified as control group)were experienced cross matching incompatibility that accounted for 0.87%.The causes were determined to be autoimmune antibodies in 10 cases,irregular antibodies in 8 cases,ABO blood incompatibility in 6 cases,cold antibodies in 2 cases,and sample contamination in 2 cases.In the 28 patients with cross matching incompatibility,the transfusion strategy included searching for blood lower than the agglutination strength of the anti human globulin test on the secondary side,re-matching,re-selecting donor blood,and selecting the correct specimen for blood matching.The transfusion results were consistent with both the primary and secondary sides.Conclusion The incidence of cross matching incompatibility among patients in the emergency department of Liuzhou Workers'Hospital in 2022 year is still relatively high,mainly due to autoimmune antibodies,irregular antibodies,ABO blood type incompatibility,etc.Actively implementing transfusion strategies such as re matching and re selecting donor blood by choosing the correct method can avoid the occurrence of cross matching incompatibility.