Rh血型系统相容性输血在儿科中的应用探讨  

The application study of Rh blood group system compatibility management in pediatric transfusion

作　　者：邵智利[1] 韩利霞[1] 马德冉[1] 刘建玲[1] 王乐[1] 陈静[2] 田野[1] 刘景汉[3] 

机构地区：[1]河北省儿童医院输血科,河北石家庄050031 [2]河北医科大学附属第三医院 [3]解放军总医院

出　　处：《中国输血杂志》2017年第3期281-284,共4页Chinese Journal of Blood Transfusion

摘　　要：目的将Rh血型系统相容性输血应用在儿科输血中。方法采用微柱凝胶法,对本院2015年5月-2016年7月临床申请输血的患儿血液标本3 254例、献血者血液标本6 851例做ABO和Rh血型表型鉴定并将检测结果录入输血信息管理系统,经过电子比对筛选,共做4 493次交叉配血。结果本组输血患儿与本地献血者的Rh表型分布频律从高到低为CCDee:38.94%(1 267/3 254)vs 41.67%(2 855/6 851),Cc DEe:38.60%(1 256/3 254)vs35.50%(2 432/6 851),Cc Dee:9.25%(301/3 254)vs 9.56%(655/6 851),cc DEE:7.87%(256/3 254)vs 7.95%(545/6851),cc DEe:4.36%(142/3 254)vs 4.11%(282/6 851),CCDEe:0.34%(11/3 254)vs 0.63%(43/6 851)、cc Dee:0.40%(13/3 254)vs 0.31%(20/6 851)、Cc DEE:0.25%(8/3 254)vs 0.28%(19/6 851)、CCDEE:0(0/3 254)vs 0(0/6851)(P<0.05);在4 493次交叉配血中,有3 273次受血者和献血者Rh抗原表型一致,713次受血者与献血者抗原非一致性但是符合相容性输注,507次输血患儿的Rh表型与献血者的不相容,Rh系统抗原相容性输血比例达到88.72%(3 986/4 493)。结论采用Rh系统相容性输血可有效地预防输血患儿免疫抗体的产生;同时可方便快捷地满足Rh系统不规则抗体阳性患儿输血和重度高胆红素血症患儿换血对血源的需求。Objective To apply the Rh compatibility system into the pediatric transfusion therapy.Methods Blood specimens from 3 254 children patients and 6 851 donors were collected from May 2015 to July 2016.The Rh groups of these participants were tested by micro-column gel method.A total of 4 493 times of cross matching assay were done with the electronic blood bank protocols.Results The Rh blood phenotypes were significantly distributed between donors and recipients （P〈0.05）.The frequencies were CCDee 38.94% （1 267/3 254） vs 41.67% （2 855/6 851）,CcDEe 38.60% （1 256/3 254） vs 35.50% （2 432/6 851）,CcDee 9.25% （301/3 254） vs 9.56% （655/6 851）,ccDEE7.87% （256/3 254） vs 7.95% （545/6 851）,ccDEe 4.36% （142/3 254） vs 4.11% （282/6 851）,CCDEe0.34% （11/3 254） vs 0.63% （43/6 851）,ccDee0.40% （13/3 254） vs 0.31% （20/6 851）,CcDEE0.25% （8/3 254） vs 0.28% （19/6 851）,CCDEE0%（0/3 254） vs 0% （0/6 851）,respectively.Among the 4 493 times of cross matching based on the Rh group,the consistent antigen phenotype was observed in 3 273 pairs,713 cases were not consistent,but compliant with the compatibility transfusion rules,507 cases were not compliant with the rules.In sum,the compatible transfusion rate reached up to 87.28% （3 986/4493）.Conclusion The Rh compatibility transfusion could prevent the antibody production in pediatric blood recipients.In addition,the transfusion demand from systemically irregular antibody-positive children and pediatric patients with severe hyperbilirubinemia can be met.

关 键 词：相容性输血 RH血型 RH抗原 交叉配血 儿科输血 

分 类 号：R457.11[医药卫生—治疗学] R720.5[医药卫生—临床医学]