477例临床输血不良反应调查及分析  

Investigation and analysis of 477 cases of adverse reactions in clinical blood transfusion

作　　者：苏莉[1] 王红波 杨家焕[1] 谭安超 王茂玲[1] 杨眉[1] SU Li;WANG Hongbo;YANG Jiahuan;TAN Anchao;WANG Maoling;YANG Mei(Department of Blood Transfusion,Guizhou Provincial People's Hospital,Guiyang 550002,China)

机构地区：[1]贵州省人民医院输血科

出　　处：《中国输血杂志》2019年第10期1027-1031,共5页Chinese Journal of Blood Transfusion

基　　金：中国医学科学院医学与健康科技创新工程(2016-12M-3-024)

摘　　要：目的调查本院5年半时间以来临床输血不良反应发生的情况,并分析其分布特点和相关原因,为深入研究输血不良反应的机制以及为建立和发展我国输血预警系统提供参考。方法通过回顾性分析本院从2013-2018年上半年经临床输血管理系统上报的《输血不良反应回报单》及查阅电子病历系统,统计发生临床输血不良反应的例数并分析发生的原因,比较各种血液成分发生临床输血不良反应的类型和发生率,总结发生输血不良反应的主要科室和主要病种。结果自2013年以来,本院输血不良反应总体发生率为0.35%(477/137297),呈逐年上升趋势,各年度输血不良反应率的差异有统计学意义(P<0.01)。反应类型以过敏反应(占0.26%)和发热反应(占0.08%)为主,未见溶血性输血反应。各血液成分的输血反应率从高到低顺序依次为单采血小板(1.19%)、血浆(0.32%)、悬浮红细胞(0.31%)、冷沉淀(0.24%)、浓缩血小板(0.18%)、去白红细胞(0.16%)和少白红细胞(0.12%)。各血液成分的反应率差异有统计学意义(P<0.01);不同红细胞间的反应率差异有统计学意义(P<0.01),少白与去白红细胞的反应率差异无统计学意义(P>0.05)。各血液成分中,血浆、单采血小板、冷沉淀其发生主要输血不良反应类型有统计学差异(P<0.01),均以过敏反应为主,而其他血液成分则无统计学差异(P>0.05)。发生输血不良反应的主要病种以急性髓系白血病最高(21%,100/477),其次是急性淋巴细胞白血病(11%,53/477),再者是肝硬化和消化道出血,相应的输血不良反应的临床科室分布以血液内科最高(47%,227/477),其次是传染科(8%,38/477)和急诊科(5%,25/477)。反复输血患者输血不良反应的发生率为0.80%,单次输血患者输血不良反应发生率为0.08%,具有统计学差异(P<0.01)。反复输血发生输血不良反应的科室与病种与发生输血不良反应的科室和病种分布基本一致。结论�Objective To investigate the incidence of adverse reactions of clinical transfusion during the past five and a half years in our hospital,and to analyze its distribution characteristics and related causes,so to provide references for further study on the mechanism of adverse reactions of transfusion as well as the establishment and development of Haemovigilance system in China.Methods The transfusion adverse reactions reported by Clinical Transfusion Management System were checked,and the patients′electronic medical records were also analyzed retrospectively.The number of adverse reactions of clinical blood transfusion was counted and the causes were analyzed.The types and incidences of clinical transfusion adverse reactions in various blood components were compared,and the main departments and diseases in which adverse reactions of transfusion occurred were summarized.Results The overall incidence of adverse reactions of transfusion in our hospital was 0.35%(477/137297)since 2013,showing an increasing trend year by year.There was statistically significant difference in the rate of adverse reactions of transfusion among different years(P<0.01).The main types of reactions were allergic reaction(0.26%)and febrile reaction(0.08%).No hemolytic transfusion reaction was observed.The transfusion reaction rate of each component from high to low was apheresis platelets(1.19%),plasma(0.32%),suspended red blood cells(0.31%),cryoprecipitate(0.24%),concentrated platelets(0.18%),leukocyte poor red(0.16%)and less white erythrocytes(0.12%).There was significant difference in the reaction rate among each blood component(P<0.01)and between different kinds of red blood cells(P<0.01),but no significant difference between leukocyte poor red and less white erythrocytes(P>0.05).There were statistically significant differences in the types of adverse reactions among plasma,apheresis,and cryoprecipitate(P<0.01),all of which were mainly allergic reactions,but there was no significant difference among other blood components(P>0.05).The t

关 键 词：输血不良反应 过敏反应 发热反应 反复输血 

分 类 号：R457.13[医药卫生—治疗学]