不同疾病RhD阴性患者成分输血策略探讨  

Exploration the Strategies of Blood Components Transfusion in RhD Negative Recipients with Different Diagnosis

作　　者：马曙轩[1] 徐樨巍[1] 宋文琪[1] 薛晖[1] 邵华[1] 刘景汉[2] 

机构地区：[1]首都医科大学附属北京儿童医院检验中心,北京100045 [2]解放军总医院输血科,北京100853

出　　处：《现代检验医学杂志》2009年第1期151-153,共3页Journal of Modern Laboratory Medicine

摘　　要：目的探索适合不同疾病的RhD阴性患者成分输血的保障策略及节约RhD阴性血液的方法。方法对解放军总医院输血前检查中检出的RhD阴性患者根据病情及输血概率的大小分为4组从而采取不同的备血策略。所有手术患者只要没有禁忌症均采用术中回收式自身输血。结果共检出95例RhD阴性患者。Ⅰ组9例患者均输血，共输注RhD阴性红细胞39U，新鲜冰冻血浆1200ml；Ⅱ组30例患者中有6例患者输血，仅输注RhD阴性红细胞9u，新鲜冰冻血浆3700ml；Ⅲ组45例患者中有12例患者仅输注自体血，其他33例患者共输注RhD阴性红细胞35U，新鲜冰冻血浆8000ml；N组11例患者共输注RhD阴性红细胞44U，新鲜冰冻血浆6500ml。结论根据RhD阴性患者的病情及手术中出血量不同采取不同的备血策略，可以保证患者手术及治疗的顺利进行并节约RhD阴性血液。Objective To explore the supplying strategies of blood components transfusion in RhD negative patients and measures to save RhD negative blood. Methods During the pre-transfusion tests in PLA general hospital,RhD negative patients were detected and divided into 4 groups according to the different possibilities of blood transfusion. Then different blood supplying measures were taken. Intra-operation autologous blood saving was carried out in all the patients without contraindications. Results In group Ⅰ ,all the 9 patients received 39 units of RhD negative erythroeyte and 1 200 ml fresh frozen plasma（FFP）. Of the 30 patients in group Ⅱ ,only 6 patients received 9 units of RhD negative erythroeyte and 3 700 ml FFP. In group Ⅲ , 12 patients underwent preoperative autologous blood donation without allogeneie transfusion. Other 33 patients received 35 units of RhD negative erythroeyte and 8 000 ml FFP. In group Ⅳ ,11 patients received 44 units of RhD negative erythroeyte and 6 500 ml FFP. Conclusion Various strategies according to the patients＇ different illness and the intra-operative blood loss can ensure safe operation and treatment,meanwhile some of the RhD negative blood source may be saved.

关 键 词：RHD阴性 血液 成分输血 自身输血 

分 类 号：R457.12[医药卫生—治疗学]