河南焦作地区2014年至2017年疑难交叉配血不合的处理及分析

Analysis and management of difficult cross-matching blood in Jiaozuo region from 2014 to 2017

目的:探讨分析疑难配血病例的原因和输血处理方法,并提出有效的处理措施。方法:2014年1月至2017年12月,焦作地区各医院中交叉配血不相合进行疑难配血的患者共78例,所有患者均进行输血前检查,并行回顾性分析总结,作出相应的处理办法。结果:78例疑难交叉配血的标本中,其中蛋白紊乱引起的假凝集4例,占疑难标本的5.1%,处理办法为试管中加入适量生理盐水;冷自身抗体现象5例,占疑难标本的6.4%,处理办法为37℃配血,并保温输血;温自身抗体13例占疑难标本的16.6%,处理办法为自身抗体吸收后进行筛查;检出不规则同种抗体56例,占疑难标本的71.9%,处理办法为筛选相合的血液给予输注。结论:引起疑难配血最主要的原因就是不规则同种抗体和温自身抗体。为了有效避免这种情况的出现,需要制定适合患者的输血方案,保证临床输血安全和有效。

Objective: To investigate the causes of difficult blood cross-matching and methods of proper blood transfusion and to propose effective managing measures. Methods: From January 2014 to December 2017, 81 patients with difficult blood cross-matching in hospitals in Jiaozuo district were recruited.All the patients were examined before transfusion and analyzed retrospectively and corresponding appropriate management measures were taken. Results: Of the 78 cases of difficult cross-matching blood samples, false coagulation caused by protein turmoil occurred in 4 cases, accounting for 5.1% of the difficult cross-matching specimens, and was managed by adding appropriate amount of normal saline in the procedure cross-matching;5 cases were with cold autoantibodies, accounting for 6.4% of difficult specimens, and managements was cross-matching under 370 C and transfusing blood under warming condition;13 cases were with warm autoantibodies, accounting for 16.6% of difficult specimens, management was performing cross-matching after adsorption of the auto-antibody;56 cases had irregular allotype antibodies detected, accounting for 71.9% of difficult specimens, management was screening appropriate compatible matching blood for transfusion. Conclusions: The most frequent causes of difficult blood cross-matching are the presence ofirregular alloantibodies and autoantibodies. For avoiding effectively this situation, it is necessary to formulate appropriate transfusion regimen suitable for the patients to ensure the safety and effectiveness of transfusion.