“三步诊断法”在临床输血病例的应用  

A retrospective analysis of the three-step diagnosis on clinic blood transfusion cases

作　　者：李丹[1] 杨波[2] 兰炯采[2] 

机构地区：[1]河南省红十字血液中心,河南郑州450000 [2]洛阳市中心血站

出　　处：《中国输血杂志》2014年第1期44-46,共3页Chinese Journal of Blood Transfusion

摘　　要：目的调查河南省多个地市发生的非传染性输血不良反应病例，提高临床输血效果。方法使用非传染性输血不良反应三步诊断法，对2010～2012年57746人次输血不良反应调查分析。结果输血病例中不良反应发生率为0．66％（383／57746）。〈24h输血反应发生310例（80．94％），24h后73例（19．06％）；溶血组12例（3．13％），非溶血组37l例（96．87％）。其中以血小板和全血的输血反应发生频率最高，分别为6．16％、4．29％。6种血液成分输血反应发生率差异有统计学意义（r：734．95，P〈0．01）。结论使用推荐的临床和实验室结合的分组法，有助干有效、快速诊断非传染性输血不良，有利于临床输血安全。Objective Given that cases of noninfectious complications of blood transfusion have happened in multiple places in Henan province, this article conducted a retrospective analysis of those cases so as to improve the effectiveness of clinic blood transfusion. Methods Using the 3-step diagnosis, complications reported from 57 746 person times were in- vestigated and analyzed. Results Complications happened to 0. 66 percent （ 383 cases） of all the blood transfusion ca- ses. Among those who showed complications, 310 cases （80. 94% ） happened within 24 hours after transfusion, and 73 ca- ses （ 19. 96% ） happened after 24 hours. 12 cases （3.13%） were categorized as hemolysis case group and the rest of them （371 cases） were non-hemolysis case group. Among the six blood constituents, thromboeyte and whole blood exhibited stronger tendency to have blood transfusion reaction, respectively 6. 16% and 4. 29%. There was significant differences be- tween the six constituents in terms of the blood transfusion reaction possibility （X2 = 734. 95,P 〈 0. 01 ）. Coneluslon To categorize cases by combing the clinic and laboratory result is helpful to diagnose the noninfectious complications of blood transfusion faster and more effectively, and hence to guarantee a safer clinic blood transfusion.

关 键 词：非传染性输血反应 三步诊断法 输血安全 

分 类 号：R457.1[医药卫生—治疗学]