一例AB型RhD(-)患者产后大出血异型输血救治  

Allotype blood transfusion treatment for a type AB RhD(-) patient suffering from postpartum hemorrhage

作　　者：周晓花 王海娟[1,2] 凤婧 朱凯[1] 陈剑[1] 赵虹[1,2] 

机构地区：[1]四川大学华西第二医院检验科,四川成都610041 [2]四川大学华西第二医院出生缺陷与相关妇儿疾病教育部重点实验室,四川成都610041

出　　处：《中国输血杂志》2017年第12期1402-1403,共2页Chinese Journal of Blood Transfusion

摘　　要：目的分享1例紧急情况下AB型RhD(-)产后大出血患者输注大量AB型RhD(+)红细胞而获得成功抢救的病例。方法在AB型RhD(-)产妇因产后大出血而RhD(-)血液无法及时提供的情况下,医院紧急启动《临床用血应急处理预案》,为患者输注AB型RhD(+)红细胞悬液16 U和大量新鲜冰冻血浆、冷沉淀以及辐照单采血小板。采用XE-2100全自动血细胞分析仪检测Hb的浓度,采用微柱凝胶卡式法进行抗体筛查和直接抗球蛋白试验。结果患者在输入大量RhD(+)血制品后,住院期间无输血不良反应发生。输血后d5,患者直接抗球蛋白试验阳性。输血后d9,患者抗体筛查仍为阴性,最后患者生命体征平稳出院。结论特殊危急情况下,在挽救RhD(-)患者的生命时可以输注RhD(+)血液,体现输血的及时性和实效性。Objective To share a successful emergency rescue case,where a type AB RhD（-） patient with postpartum hemorrhage was transfused witha large volume of type AB RhD（ ＋） blood.Method Due to the lack of RhD（-） blood supply in the blood center at the time,the hospital initiated＂the Emergency Plan of Clinical Transfusion＂.The patient was transfused with type AB RhD（ ＋） red blood cells,16 U along witha large volume oftype AB RhD（ ＋） fresh frozenplasma,cryoprecipitate and irradiated platelets. An XE-2100 Automatic Blood Cell Analyzer was adopted tomeasure the concentration of Hb. Microcolumn gel tests were performed for antibody screening and direct antihuman globulin.Results The patient withRhD（ ＋） blood transfusion presented no adverse transfusion reaction during her hospitalization. The direct antihuman globulin of the patient turned positive d5 while the antibody screening tests held negative till d9.Finally,the patient recovered smoothly and no more hospitalization was needed.Conclusions In aspecial emergency situation,the transfusionof RhD（ ＋） blood for RhD（-） patients should be permitted to save life,which strictly followsthe requirement of timeliness and effectiveness in blood transfusion.

关 键 词：AB型RhD(-) 产后大出血 输血 

分 类 号：R457.11[医药卫生—治疗学] R714.461[医药卫生—临床医学]