发热性非溶血性输血反应的危险因素分析与预防控制  

Febrile non hemolytic transfusion reaction:risk factors and prevention

作　　者：王爱红[1] 毛雄伟[1] 徐林燕[1] 

机构地区：[1]江山市人民医院中心血库,浙江江山324100

出　　处：《健康研究》2017年第4期369-371,375,共4页Health Research

摘　　要：目的研究输血患者发生发热性非溶血输血反应(Febrile non-hemolytic transfusion reaction,FNHTR)危险因素,并分析预防控制的对策。方法选取医院2011—2014年发生发热性非溶血性输血反应的患者48例,分析相关危险因素,对疑似细菌污染性输血反应的8例受血者及其对应8例供者血液进行血培养并采用软件统计学分析。结果 2011—2014年共输血24805次,发生FNHTR48次,发生率0.19%;其中受血者年龄>60岁、有输血史、女性、输注悬浮红细胞、使用的血液失效期≤5d时,FNHTR的发生率明显上升,各组内比较差异均有统计学意义(P<0.05)。共送检8例患者的血培养标本,结果 3例阳性,阳性率37.5%;送检的8例供血者的血培养标本,结果 1例阳性,阳性率12.5%;1例阳性供血者血液来自2012年失效期5~15d的悬浮红细胞。受血者和供血者血培养共分离出4株病原菌,均为革兰阴性杆菌,其中大肠埃希菌占100%;大肠埃希菌对亚胺培南和阿米卡星的耐药率最低,分别为1.6%和3.7%;而头孢曲松和呱拉西林的耐药率分别达83.9%和79.4%。结论 FNHTR的危险因素包括高龄、有输血史、妊娠史、失效期短、未去白细胞的悬浮红细胞,医院应继续加强对临床科学合理用血的监管力度,确保血液质量,降低FNHTR的发生率。Objective To study of FNHTR transfusion in patients with risk factors, and analysis of Countermeasures of prevention and control. Method 48 cases of patients with febrile non hemolytic transfusion reaction hospitalized during 2011 -2014 were chosen as the subjects of study. The relevant risk factors were analyzed. The blood of 8 cases of suspected bacterial contamination of the transfusion reaction and that of 8 corresponding donors were subjected to blood culture and statistical analysis software was used to conduct the analysis. Findings During 2011-2014 24805 times of blood transfusion were documented with 48 cases of. The incidence rate of FNHTR was 0.19%. The incidence rate of FNHTR increased where the recipient being 〉 60 years of age, having a history of blood transfusion, being female, receiving transfusion of suspending red cells, using blood whose effect expires in less than or equal to 5D. The incidence of FNHTR increased obviously. The difference was statistically significant （P〈 0.05）. 8 cases were submitted the patient＇ s blood culture specimens, the result was positive in 3 cases, the positive rate was 37.5% ; the samples of 8 patients with donor submission of blood culture, the result was positive in 1 cases, the positive rate was 12.5% ; 1 cases with positive blood donors blood from the 2012 failure period is 5 - 15d suspended red blood cells; blood recipients and donors were isolated from blood cultures 4 strains of pathogenic bacteria were gram-negative bacillus, Escherichia coli, which accounted for 100%; Escheriehia coli resistant to imipenem and Amikacin was the lowest, respectively 1.6% and 3.7%; and resistant to ceftriaxone and quack Rasilin rate reached 83.9% and 79.4% respectively. Conlusion Risk factors for FNHTR include suspended red blood ceils, old age, a history of blood transfusion, pregnancy history, failure period short, not to white blood cells, the hospital should continue to strengthen the clinical reasonable use of supervision of blood, to ensure the blood quality,

关 键 词：发热性非溶血输血反应 病原菌 危险因素 对策 

分 类 号：R4[医药卫生—临床医学]