北京市某三甲医院输血不良反应回顾性分析  

Characteristics and mechanism analysis and prevention of adverse transfusion reactions

作　　者：陈利达[1] 芦宏凯[1] 王璐璐[1] 郭伟洁[1] 郑超[1] 王文静[1] 王琪[1] 王淑萌 刘希曦[1] 曹永彤[1,2] 

机构地区：[1]中日友好医院输血科,北京100029 [2]中日友好医院检验科,北京100029

出　　处：《中国输血杂志》2016年第2期186-188,共3页Chinese Journal of Blood Transfusion

摘　　要：目的通过分析临床输血不良反应的特征和机制,增强未来对不良反应的预防和应对能力。方法 2012年1月-2014年12月日查阅本院所有输血记录、输血不良反应患者病历,分析不良反应发生的性质、特征、概率和机制。结果输血不良反应率为0.43%(33/7 673)。不良反应最常见的是过敏反应,占72.7%(24/33),其次为非溶血性发热反应,占24.2%(8/33),不良反应率呈逐年下降趋势,分别为0.53%(14/2 646)、0.41%(10/2 449)和0.35%(9/2 578)。3年内输注血制品共49 674袋,其中悬浮红细胞、单采血小板和新鲜冰冻血浆的不良反应发生率分别为0.48%(10/2 067)、0.08%(6/7 251)和0.07%(16/21 925),明显高于其他血液成分。发生不良反应的患者以干部保健一病区14.8%(4/27)和重症监护室4.9%(5/102)居多。老年、有输血史、孕产史的患者容易发生不良反应。结论本院输血不良反应总体发生率较低;提倡少白细胞血制品的应用;老年、有输血史、孕产史、重症患者输血要特别预防和监测;应完善不良反应回报制度,安全输血。Objective To enhance the ability to avoid ad- verse reactions by analyzing the characteristics and mechanisms of adverse transfusion reactions. Methods All transfusion re-cords from Chlna-Japan Friendship Hospital from year 2012 to 2014 were analyzed. The nature of adverse transfusion reac- tion, characteristics, probabilities and mechanisms were explored. Results A total of 7 673 people have been treated with blood transfusion within three years, of which 33 cases had adverse transfusion reactions, at a rate of O. 43%. The highest incidence of adverse reactions was due to allergies （72. 7% ,24/33）, followed by fever （24. 2% ,8/33）： Adverse reaction rates showed a declining trend each year, from 0. 53% （ 14/2 646） in 2012, 0.41% （ 10/2 449） in 2013 to 0. 35% （9/2 578） in 2014. The adverse reaction rates of suspense red blood cells, platelets and fresh frozen plasma were 0. 48% （ 10/2 067 ）, 0. 08% （6/7 251 ） and 0, 07% （ 16/21 925 ）, respectively. The majority of adverse reactions occurred in patients in cadre care ward and ICU, at the rates of 14. 8% （4/27） and 4. 9% （5/102）. Conclusion The hospital has a lower rate of adverse transfusion reactions. Patients who are older, and/or have history of blood transfusion, pregnancy, in ICU, should be paid special attention. Blood transfusion should be strictly monitored. The blood system should be standardized in order to minimize the occurrence of adverse transfusion reactions.

关 键 词：输血不良反应 成分输血 标准化 

分 类 号：R457.13[医药卫生—治疗学]