红细胞输注无效的原因与安全输血

发布时间：2018-07-29 07:29

【摘要】：目的观察住院患者输注红细胞的效果,分析影响红细胞输注效果的因素,为临床科学、合理输血提供依据。方法用回顾性分析的方法对本院2016年1月-3月486例红细胞输患者的临床病志、输血资料以及直接抗球蛋白试验的检验结果进行统计和分析。结果 486例住院患者共输注红细胞1 028次,其中无效输血有182次,输注无效率为17.7%,既往输血次数3次、输血量16 U红细胞输注无效率分别为42.7%与39.4%,比输血次数3次、输血量16 U红细胞输注无效率发生高;有妊娠史的患者红细胞输注无效的发生率为22.19%,比无妊娠史发生率高;恶性肿瘤患者与血液病患者红细胞输注无效的发生率分别为35.8%与25%,相比其他疾病发病率高;直接抗球蛋白试验阳性(31.6%)比阴性发生红细胞输注无效(14.1%)的几率增高。结论患者的疾病种类、既往输血次数、输血量、妊娠史及直接抗球蛋白试验的结果对输血效果的影响较为明显,临床医生应严格执行科学合理输血,尽量减少输血次数、重视直接抗球蛋白阳性结果,分析其阳性的原因,节约宝贵的血液资源。
[Abstract]:Objective to observe the effect of red blood cell transfusion in inpatients and analyze the factors that affect the effect of red blood cell transfusion, so as to provide the basis for clinical science and rational blood transfusion. Methods the clinical records, blood transfusion data and the test results of direct antiglobulin test in 486 patients with erythrocyte transfusion from January to March 2016 were analyzed retrospectively. Results A total of 1 028 erythrocytes were infused in 486 inpatients, of which 182 were ineffective blood transfusion, the inefficiency was 17. 7, 3 times of previous blood transfusion, the invalid rate of 16 U red blood cell transfusion was 42. 7% and 39. 4% respectively, which was 3 times than that of blood transfusion. The incidence of ineffective red blood cell transfusion in patients with pregnancy history was 22.19, which was higher than that without pregnancy history. The incidence of ineffective red blood cell transfusion was 35.8% in malignant tumor patients and 25% in hematopathy patients, which was higher than that of other diseases, and the probability of failure of erythrocyte transfusion was higher in direct antiglobulin test (31.6%) than that in negative erythrocyte transfusion (14.1%). Conclusion the types of diseases, the number of previous blood transfusions, the quantity of blood transfusion, the history of pregnancy and the results of direct antiglobulin test have obvious effects on the effect of blood transfusion. The clinicians should strictly carry out scientific and reasonable blood transfusion to reduce the number of blood transfusions as far as possible. Attach importance to direct antiglobulin positive results, analyze the causes of positive, save precious blood resources.
【作者单位】：辽宁中医药大学附属医院输血科;
【分类号】：R457.1

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