连续3次输血引发输血相关急性肺损伤——附1例报告  

Transfusion-related acute lung injury after three times of transfusion:case report

作　　者：张利[1] 朱国标[1] 黄菲[1] 甘新宇[1] 徐弘[1] 何花[1] 于丽君[1] 李翠莹[1] 

机构地区：[1]成都军区总医院输血科,四川成都610083

出　　处：《中国输血杂志》2015年第5期558-561,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨该例输血相关急性肺损伤(TRALI)的发生机制,为该疾病的及时诊断和有效治疗提供参考。方法回顾性查阅该病例相关的病程记录、输血资料、实验室检查及影像学数据,诊断标准参照欧洲血液预警网络基于临床特征的TRALI诊断标准[1]。结果该患者在3次输注血小板治疗后出现的呼吸困难、低血氧浓度、双肺纹理增多等临床表现,符合TRALI诊断,同时表现血小板输注无效。结合实验室检查结果,该TRALI疑为患者淋巴细胞抗体与供者相应抗原结合引起。结论 TRALI为严重少见的输血不良反应,临床和输血科应加强认识,及时诊断治疗;加强输血治疗合理性论证,避免不必要的输血不良反应及血液资源的浪费。Objective To explore the mechanism of transfusion-related acute lung injury （TRALI） in one ease, and to provide reference for the diagnosis and treatment strategy for TRAIT. Methods Clinical records, transfusion data, and laboratory data were studied retrospectively. Literatures were also reviewed. Diagnosis of TRAIT followed the criteria provided by European hematology network. Results The patient experienced dyspnea, hypoxemia and increased lung markings, thus met the diagnosis criteria of TRAIT. Platelet transfusion refractoriness was also observed in the case. Conclusion TRALI are important, life-threatening complications of transfusion. Doctors should be alert to the occurrence of TRALI when rapidly progressive hypoxemia appeared after transfusion of blood products. Early diagnosis and quick treatment are the keys to improving survival in these patients.

关 键 词：输血相关急性肺损伤 白血病 输血 HLA抗体 

分 类 号：R457.1[医药卫生—治疗学] R563.8[医药卫生—临床医学]