直抗阳性患者的几种简化配血方法评估

发布时间：2018-05-07 01:18

本文选题：直抗 + 直接抗球蛋白试验　；参考：《中国输血杂志》2016年11期

【摘要】：目的通过研究直抗阳性血样的血清学特点,探讨不同的简化配血方案的安全性。(常见的简化方法包括盲配后挑选反应较弱血液的供血;主侧配血与自身对照比较后的供血;ABO、Rh同型供血等)。方法回顾性分析本中心2013年11月-2015年6月直抗阳性患者101名和历年输血不良反应患者17例,其血清或放散液均经过同种或类同种抗体鉴定。通过分析其自身对照,抗体筛选,鉴定试验,配血试验的反应结果,判断不同简化的配血方法可能存在的风险。结果统计未检出特异性抗体占59.32%(70/118);检出同种抗体及/或自身抗体占37.29%(44/118);检出类同种特异性抗体占3.39%(4/118);其中确定为Rh抗体占89.58%(43/48)、确定为Rh以外的其它抗体占10.41%(5/48);118例DAT阳性患者在聚凝胺及抗人球反应介质下配血时,主侧配血管反应强度大于自身对照管占28.57%(28/98)、主侧配血管小于自身对照管占71.43%(70/98)。结论对于DAT阳性患者,各种简化配血方法中,ABO、Rh同型输血风险较低,主侧配血与自身对照比较后的供血方法以及盲配方法的风险较大。
[Abstract]:Objective to study the serological characteristics of direct anti-positive blood samples and to explore the safety of different simplified blood matching protocols. (the common simplified methods include the selection of blood supply of weaker blood after blind matching, and the homotypic blood supply of ABOOG Rh after main side matching and self control. Methods from November 2013 to June 2015, 101 patients with positive direct antibody and 17 patients with adverse reaction of transfusion in our center were retrospectively analyzed. Their serum or exuberant were identified by homologous or similar antibodies. By analyzing the results of autocontrol, antibody screening, identification test and blood matching test, the possible risks of different simplified blood matching methods were judged. Results No specific antibody was detected (59.32% / 118g); homoantibodies and / or autoantibodies were detected in 37.29% of 118g / 118s; and the same specific antibodies were detected in 3.39g / 4 / 118G; Rh antibodies were identified as Rh antibodies (89.58% / 48C), and other antibodies other than Rh antibodies accounted for 10.41r548t / 118 cases of DAT positive patients. In the medium of polyglutamide and antihuman sphere reaction, The reaction intensity of the main collateral vessels was more than that of the autocontrol vessels (28.57 / 98) and the main collateral vessels were less than that of the self-control vessels (71.43% / 98%). Conclusion for DAT positive patients, the risk of homotypic blood transfusion is lower in all kinds of simplified matching methods, and the risk of blood supply method and blind matching method after main side blood matching is higher than that of self-control.
【作者单位】：上海市血液中心;
【基金】：上海市公共卫生重点学科建设项目(15GWZK0501)
【分类号】：R457.11

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