疑难血型鉴定及处理分析  

The identification and analysis of 56 cases with ambiguous blood typing results

作　　者：张妍 宋玥 李娜[1] 张凯[1] ZHANG Yan;SONG Yue;LI Na;ZHANG Kai(Department of Blood Transfusion , Tianjin Hospital, Tianjin 300211, China.)

机构地区：[1]天津医院输血科

出　　处：《中国输血杂志》2018年第5期534-536,共3页Chinese Journal of Blood Transfusion

摘　　要：目的分析研究ABO疑难血型的产生原因,探讨正确的鉴定方法,以确保血型鉴定的准确性。方法采用微孔板法对本院住院患者进行ABO血型正,反定型初筛检测。采用试管法对出现疑问的标本进行复检,并根据情况做吸收放散试验,不规则抗体筛查试验,抗球蛋白试验,以及特异性鉴定等以进行确定患者血型。结果本院2015—2016年住院患者进行血型鉴定共计45 681例,排除标本差错,共出现ABO血型正反不符标本56例（0.12%）,其中：抗体减弱42例（75%）,抗原减弱3例（5.4%）,冷自身抗体2例（3.5%）,同种抗体6例（10.7%）和亚型3例（B（A）型和B亚型5.4%）。结论排除标本差错与污染,当出现ABO正反定型不符时,应根据患者资料,进行正确的分析判断,选择正确的试验,进行重新检测,确保血型结果的准确性。通过对结果的分析,导致血型正反不符的原因是多方面的,工作人员必须增强责任心,查明原因,准确鉴定血型,确保临床输血的安全有效。Objective This study aims to ensure the accuracy of blood typing by analyzing the causes of ambiguous ABO blood typing results and proposing viable identification methods. Methods The microplate methods are used for the forward and reverse blood typing prescreening on the patients in our hospital. The test tube method is applied to recheck the unidentified samples. Other methods are taken to recheck blood typing results depending on the sample condition,such as the absorption and elution test,the irregular antibodies screen test,the antiglobulin test and the specific identification. Results A total of 45 681 samples in our hospital were tested. After excluding sample error,forward and reverse blood typing showed 56 inconsistent cases（ 0. 12%）. Among them,42 were antibody weakening（ 75%）,3 were antigen weakening（ 5. 4%）,2 were cold autoantibodies（ 3. 5%）,6 were alloantibodies（ 10. 7%） and 3 were subtypes cases（ type B（ A） and type B,5. 4%）. Conclusion When blood samples are confirmed by inconsistent forward/reverse typing,it is crucial to analyze the patient condition and design experiment plans accordingly. The inconsistent blood typing results can be caused due to various reasons. Concerned staff need to strictly follow protocols to identify patient blood types accurately and thus ensure the safety of blood transfusion.

关 键 词：ABO血型系统 血型正反定型 血型亚型 输血安全 

分 类 号：R457.11[医药卫生—治疗学]