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患者男性,22岁,未婚。因先天性心脏病,初动脉导管未闭术后再通,于1985年8月24日入院。入院后,查血常规:Hb 112g/L,RBC 3.78×10~(12)/L,WBC 6×10~9/L、N 70%、L 30%,血型ABO为B型。在普通低温全麻下进行手术,经过顺利。术中输血600ml。输血时曾有反应(寒战等)。入院后19天因病情需要再输B型血200ml,仍有寒战等反应,同时出现血红蛋白尿,以致血未输完(余50ml)就停止。第二天输B型血400ml,同样有输血反应,且一次比一次重,Hb继续下降,病人情况恶化,于是立即会诊。会诊讨论中认为:患者在术后3天中,总输血量达950ml,但血红蛋白反而比术前急剧下降,病情危重。应继续输血及治疗,目前血红蛋白严重下降的最大可能是输血引起。会诊后血库立即又为病人查血型,ABO为B型,Rh血型为阳性CcDEe;Cuombs直接试验为阴性;抗体效
Male patient, 22 years old, unmarried. Due to congenital heart disease, primary patent ductus arteriosus and then pass, in August 24, 1985 admission. After admission, blood routine examination: Hb 112g / L, RBC 3.78 × 10-12 / L, WBC 6 × 10-9 / L, N 70%, L 30%, blood type ABO is B type. Under general anesthesia for low temperature surgery, after a smooth. Intraoperative blood transfusion 600ml. Blood transfusion had reaction (chills, etc.). 19 days after admission due to illness need to lose B type blood 200ml, there is still chills and other reactions, while hemoglobinuria, resulting in blood has not lost (I 50ml) to stop. The next day B-type blood transfusion 400ml, the same transfusion reaction, and once more than once, Hb continued to decline, the patient’s condition deteriorated, so immediately consultation. Consultation discussion that: patients in the three days after surgery, the total blood transfusion reached 950ml, but hemoglobin sharp decline in preoperative, but critically ill. Should continue to blood transfusion and treatment, hemoglobin is currently the most serious decline may be caused by blood transfusion. Immediately after consultation, the blood bank of patients was also examined for blood type, ABO was type B, Rh blood type was positive CcDEe; Cuombs direct test was negative; antibody efficacy