反复输血患者体内产生不规则抗体的临床分析及解决策略

发布时间：2018-03-30 06:38

本文选题：输血　切入点：不规则抗体　出处：《中国输血杂志》2016年12期

【摘要】：目的探讨在临床上多次输血患者体内产生不规则抗体的情况及输血解决策略。方法回顾性分析2015年1月-2016年4月,本院住院患者中符合输血至少2次以上,且第1次输血前不规则抗体筛查为阴性,之后至少有1次输血前不规则抗体筛查阳性,并与库存至少20单位同型献血者血液交叉配血,部分或全部不相合的患者9名,并对此9名患者进行血型鉴定、不规则抗体筛查及进一步抗体鉴定等多种血型血清学试验,确定抗体类型并结合临床病史,给与适合血液输注。结果随着患者输血量和输血次数的增加,患者体内出现不规则抗体的机率增大、抗体类型也越为复杂,致使血型鉴定及交叉配血困难,寻找相合血液输注的机率越小。结论对有输血史及妊娠史的患者应常规进行不规则抗体筛查,及时发现有临床意义的抗体,确保临床用血及时、安全、有效。
[Abstract]:Objective to investigate the status of irregular antibodies produced in patients with multiple transfusions in clinic and the strategies for solving them. Methods retrospective analysis was made on the patients in our hospital who were admitted to our hospital from January 2015 to April 2016, with at least two blood transfusions. The irregular antibodies were negative before the first transfusion, and were positive at least once after the first transfusion, and were cross-matched with at least 20 units of blood donors in stock, some or all of them were not identical with each other. Blood type identification, irregular antibody screening and further antibody identification were carried out in these 9 patients to determine the type of antibody and combined with clinical history. Results with the increase of blood transfusion volume and times of blood transfusion, the probability of irregular antibodies in patients increased, and the types of antibodies became more complicated, resulting in difficulties in blood type identification and cross-matching. Conclusion patients with history of blood transfusion and pregnancy should be routinely screened for irregular antibodies to find antibodies of clinical significance in order to ensure timely, safe and effective clinical use of blood.
【作者单位】：首都医科大学宣武医院输血科;首都医科大学;
【基金】：首都医科大学本科生创新科研项目(xsky2015114)
【分类号】：R457.1

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