特殊情况下紧急抢救输血病例的临床输血情况分析

发布时间：2018-11-11 21:10

【摘要】：目的以《特殊情况紧急抢救输血推荐方案》(简称《紧急输血方案》)指导临床在ABO同型血液储备无法满足需求时的紧急抢救输血实施。方法收集本院外科2014年1月-2015年12月临床手术用血1 600 m L的相关病例164例,分为紧急抢救输血组(紧急输血组):ABO同型血液储备无法满足需求的患者紧急抢救输血病例7例;对照组:ABO同型血液储备满足需求的输血病例157例。分析并比较2组患者的ABO血型,术前交叉配血量/实际输血量值(C/T),凝血功能,输血后3 d、7 d的Hb以及直接抗球蛋白试验(直抗)和抗体筛查试验(抗筛)。结果紧急输血组与对照组分别为AB血型占85.7%(6/7)vs 5.7%(9/157)(P0.01);紧急输血组与对照组中肝脏移植术患者术前APTT(s)为58.5±20.1 vs 29±13.4,TT(s)为27.3±8.1 vs 20.8±7.8(P0.05)。AB型原位肝移植且术前凝血功能异常的患者易发生ABO同型血液储备无法满足需求的情况,输注O型红细胞后Hb可达到预期效果(P0.05)。紧急输血组患者C/T值最低,临床备血严重不足。结论 ABO同型血液储备无法满足需求时致患者紧急抢救输血的发生由多种因素造成,《紧急输血方案》为临床紧急抢救输血提供了科学、切实可行的方法和操作程序。
[Abstract]:Objective to guide the clinical practice of emergency blood transfusion when the same type of blood reserve of ABO can not meet the needs of emergency rescue transfusion with "Special case Emergency Rescue Blood Transfusion Program" (abbreviated as "Emergency Blood Transfusion Program"). Methods 164 patients with 1 600 mL of blood used in surgery from January 2014 to December 2015 were collected. The patients were divided into emergency rescue transfusion group (emergency transfusion group) 7 patients whose): ABO blood reserve could not meet the needs of emergency rescue transfusion. Control group: 157 cases of blood transfusion with the same blood reserve of ABO. The ABO blood group of the two groups were analyzed and compared. The blood cross-matching volume / actual transfusion volume (C / T), coagulation function, Hb at 3 days and 7 days after transfusion, direct anti-globulin test and antibody screening test (anti-screening test) were analyzed and compared. Results AB blood group accounted for 85.7% (6 / 7) vs 5.7% (9 / 157) in emergency transfusion group and control group (P0.01). The preoperative APTT (s) in the emergency transfusion group and the control group was 58.5 卤20.1 vs 29 卤13.4, respectively. TT (s) was 27.3 卤8.1 vs 20.8 卤7.8 (P0.05) in patients with). AB orthotopic liver transplantation and abnormal coagulation function before operation, the same blood reserve of ABO could not meet the demand. After O-type erythrocyte infusion, Hb could achieve the expected effect (P 0.05). In the emergency transfusion group, the value of C / T was the lowest and the clinical blood preparation was seriously inadequate. Conclusion the occurrence of emergency blood transfusion caused by the same type of ABO blood reserve is caused by many factors. The emergency blood transfusion program provides a scientific, feasible method and operational procedure for clinical emergency rescue blood transfusion.
【作者单位】：复旦大学附属华山医院输血科;解放军总医院;南方医科大学南方医院;
【基金】：国家自然科学基金面上项目(81470351)
【分类号】：R457.1

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