自身免疫性溶血性贫血患者输血前试验的应用价值  

Experimental study on blood transfusion in patients with autoimmune hemolytic anemia

作　　者：林俊华 

机构地区：[1]福建省漳州市中心血站,福建漳州363000

出　　处：《医疗装备》2016年第24期19-20,共2页Medical Equipment

摘　　要：目的探究自身免疫性溶血性贫血(AIHA)患者输血前试验的应用价值。方法选取2013年10月至2015年10月纳入的494例AIHA患者,检测指标共计5项,分别为:ABO/Rh D血型鉴定、DTT处理自凝红细胞、自身抗体吸收检测、抗体筛选及鉴定试验,以及直接抗人球蛋白试验。结果检测结果显示,本组494例中,温自身抗体患者占85.43%(422/494),冷自身抗体患者占5.26%(26/494),混合型自身抗体患者占9.31%(46/494)。抗体筛选结果显示,本组422例温自身抗体患者的血样盐水介质试验检测结果为阴性,提示并未同时存在lg M同种抗体。交叉配血结果显示422例温自身抗体患者中,326例无特异性抗体的患者采用LISS/Coombs法检测,交叉配血结果显示,138例吻合,188例发生排斥。输血结果显示270例配血吻合者均经给予输血处理,其中193例患者输注洗涤红细胞,76例患者输注悬浮红细胞。结论采用科学、严谨的检测技术,完成对AIHA患者输血前的各项检查,如抗体鉴定、血型鉴定等,并以此为依据,进行交叉配血试验,能够极大程度上避免输血不良事件的发生,提高抢救成功率。在救治AIHA患者的过程中,务必要严格对待血型鉴定、抗体筛查与交叉配血等检查工作,以确保输血安全性。Objective To explore the application value of blood transfusion in patients with autoimmune hemolytic anemia. Methods 494 patients with AIHA were selected in our hospital from October 2013 to October 2015,indexes of study a total of 5,respectively： detection,antibody screening and identification test and direct anti human globulin protein test attracting the self coagulation of red blood cells and autoantibodies ABO/Rh D blood group identification,DTT treatments. Results The results showed that in this group of 494 patients,temperature autoantibodies accounted for 85. 43%（422/494）,cold autoantibodies accounted for more than（26/494）,mixed autoantibodies accounted for more than 9. 31%（ 46/494）. Antibody screening results showed that 422 cases of patients with warm autoantibodies in the blood samples of saline test results were negative,suggesting that no lg M isotype antibodies exist simultaneously. Cross matching results showed that 422 cases of warm autoantibody patients, no specific antibodies in patients with LISS/Coombs detection,cross matching results showed that in 138 cases of anastomosis,the exclusion of the 188 cases. Blood transfusion results showed that 270 patients with blood transfusion were given transfusion,of which 193 patients were washed red blood cells,infusion of suspended red blood cells in 76 patients. Conclusions The scientific and precise detection technology,of AIHA patients before blood transfusion of the inspection,such as identification of the antibodies,blood group identification,and on this basis,blood cross matching test,can largely avoid the occurrence of transfusion adverse events,improve the success rate of rescue. In the course of clinical treatment of AIHA patients,be sure to strictly treat blood type identification,antibody screening and cross matching blood examination work,in order to ensure the safety of blood transfusion.

关 键 词：自身 免疫性 溶血性 贫血 输血前试验 

分 类 号：R556.6[医药卫生—血液循环系统疾病]