临床输血不良反应原因分析及对策  

The causes analysis of clinical blood transfusion adverse reactions and counteractions

作　　者：常洪劲[1] 许静静[1] 李岩[1] 

机构地区：[1]济宁医学院附属医院,济宁272029

出　　处：《济宁医学院学报》2016年第4期254-257,共4页Journal of Jining Medical University

摘　　要：目的分析发生输血不良反应(blood transfusion adverse reactions,BTAR)的可能原因并制订应对措施,进一步减少或避免类似BTAR的发生。方法收集2013年1月至2014年12月期间发生的BTAR 59例及所有输血人次44983人次,分析发生BTAR的时滞、不同血制品的不良反应发生率、不良反应对机体的危害、科室分布及患者预后。结果所有不良反应均发生在开始输血6h内,即为即发型输血反应。即发型输血反应最多见的症状是过敏与发热。发生BTAR的血制品包括病毒灭活冰冻血浆、单采血小板、冷沉淀凝血因子、去白细胞悬浮红细胞,其中血浆的不良反应发生率最高。不良反应的发生科室以ICU居多。经救治后,不良反应所造成的伤害均痊愈。结论发生BTAR的原因主要是患者本身对血浆内免疫球蛋白过敏,或已产生白细胞抗体。通过对症处理、输血前常规给予抗过敏药和解热药、选用抗原相配合的血制品及去除白细胞的血制品这些途径可减少或避免BTAR的发生。Objective To analyze the possible reasons of blood transfusion adverse reactions and consti- tute the counteractions for further reducing or preventing similar blood transfusion adverse reactions. Methods The fifty-nine cases of blood transfusion adverse reactions and all the 44983 person-time of blood transfu- sion were collected between January 2013 and December 2014. And then we analyzed the time-lag, the inci- dence rate of BTAR in different blood products, the harm of the body from BTAR, department and patients＇ outcome. Results All the BTAR occurred in the 6 hours in the beginning of blood transfusion, which were called acute transfusion reactions. Skin allergy and fervescence were the major symptoms of acute transfusion reaction. The blood products of blood transfusion adverse reactions included virus inactivated frozen plasma, platelets, cryoprecipitate, and suspended leukocyte reduced red blood cells. Among the blood products of transfusion adverse reactions, the BTAR incidence rate of plasma occupy the multiple. The ICU were the ma- jor department. After treatment, the damage caused by adverse reactions were recovered. Conclusion The occurrence of blood transfusion adverse reactions were maiuly patients themselves allergic to immunoglobu- ]in within the plasma,or the patients had produced leucocyte antibody. By symptomatic treatment, it was to give antiallergic drug and febrifuge before blood transfusion routinely and the antigen in coordination with each other and leukocyte reduced blood products which could reduce or avoid the occurrence of blood trans- fusion adverse reactions.

关 键 词：输血 不良反应 原因分析 对策 

分 类 号：R457.1[医药卫生—治疗学]