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目的对存在特异性不明确的同种抗体患者,通过分析血清学特征及评估红细胞输注效果,评价配血方法的安全性。方法回顾性分析本院2013-2014年度不规则抗体筛查阳性且血清学方法无法明确抗体特异性的患者139例,并应用临床输血智能管理与评估系统对81例输注红细胞的患者进行效果评价。结果 139例患者中,抗体类型分5种,效价低、活性弱抗体占多数。139例患者中红细胞输注81例,输注红细胞114次。其中输注有效率77.2%;部分有效率22.8%;输注无效率0%。不同类型抗体输注有效率与部分有效率无显著性差异(P>0.05)。81例输注红细胞患者中,男性34例,有输血史者19例(55.9%);女性47例,有输血史者43例(91.5%)。所有输血病例均无溶血性输血反应发生。结论红细胞输注前,不规则抗体筛查是必要的,尤应注意有输血史病例。即使血清学方法无法明确抗体特异性,必须同时用盐水法和微柱凝胶法做交叉配血试验,选择相合的血液输注。避免红细胞输注无效、输血不良反应的发生,节约血液资源,提高输血安全。
Objective To evaluate the safety of the method of matching blood by analyzing the serological characteristics and assessing the effect of erythrocyte infusion on alloantibodies with unclear specificity. Methods A retrospective analysis of our hospital from 2013 to 2014, irregular antibody screening positive and serological methods can not be clear antibody-specific patients 139 cases, and clinical management of blood transfusion by intelligent management and evaluation of 81 cases of patients with erythrocytes transfusion efficacy evaluation . Results Of the 139 patients, the antibody types were divided into five types with low titer and weakly active antibody. In 139 patients, 81 patients received erythrocyte infusion and 114 patients received red blood cell transfusion. Including infusion rate of 77.2%; part of the effective rate of 22.8%; infusion ineffective 0%. Different types of antibody infusion efficiency and partial efficiency no significant difference (P> 0.05). Of 81 patients with erythrocyte transfusion, 34 were male and 19 had transfusion history (55.9%); 47 were women, and 43 (91.5%) had transfusion history. All hemolytic transfusion reactions did not occur in all transfusion cases. Conclusion Before the red blood cells transfusion, irregular antibody screening is necessary, especially the case of transfusion history should be noticed. Even if the serological method is not clear antibody specificity, must be used at the same time by saline method and micro-column gel cross-matching blood test, select the appropriate blood transfusions. To avoid ineffective red blood cell transfusion, transfusion adverse reactions, save blood resources, improve blood transfusion safety.