53例患儿疑难配血原因分析与输血对策探讨  

Analysis the causes and countermeasures of blood transfusion in 53 cases of pediatric patients with incompatible cross-matching

作　　者：彭小友 周杰英[1] 阳爱丽 史文元[1] 邓怀峰[1] 李胜涛[1] PENG Xiaoyou;ZHOU Jieying;YANG Aili;SHI Wenyuan;DENG Huaifeng;LI Shengtao(Department of Laboratory Medicine Center,Chenzhou Municipal First People′s Hospital,Chenzhou,Hunan 423000,China)

机构地区：[1]湖南省郴州市第一人民医院检验医学中心

出　　处：《检验医学与临床》2020年第5期600-602,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨儿科患者疑难配血的原因及输血对策。方法对郴州市第一人民医院北院(郴州市儿童医院)2017年1月至2019年3月的53例疑难配血标本进行ABO血型正反定型、Rh表型鉴定、吸收放散试验、抗人球蛋白试验、不规则抗体筛查及鉴定试验等相关检测,找出导致配血困难的原因,依据原因采用相应的输血对策。结果53例疑难配血患儿中,以新生儿疑难配血发生率最高(75.5%)。新生儿疑难配血中,ABO血型不合溶血病发生率最高(18例),其次为抗-D溶血病(6例)和纤维蛋白丝干扰(6例)。非新生儿疑难配血中,自身免疫性溶血性贫血(AIHA)7例、同种抗-M 5例、同种抗-E 1例。采用相应输血策略后,仅2例患儿出现输注无效,其余患儿输血效果良好。结论儿科患者疑难配血的原因较多,ABO血型不合溶血病、AIHA分别为导致新生儿与非新生儿疑难配血的主要原因。Objective To investigate the causes and blood transfusion countermeasures of incompatible cross-matching in pediatric patients.Methods ABO blood group test,Rh phenotype identification,absorption and dispersion test,antiglobulin test,irregular antibody screening and identification test were performed on 53 blood specimens with incompatible cross-matching from January 2017 to March 2019 in North Hospital of Chenzhou Municipal First People′s Hospital(Chenzhou Children′s Hospital),to found out the reasons that lead to incompatible cross-matching,and adopted corresponding blood transfusion countermeasures based on the reasons.Results Among 53 children,the incidence of incompatible cross-matching was highest in newborns(75.5%).Among newborns,ABO hemolytic disease had the highest incidence(18 cases),followed by anti-D hemolytic disease(6 cases)and fibrin silk interference(6 cases).Among non-newborns,there were 7 cases of autoimmune hemolytic anemia(AIHA),5 cases of anti-M alloantibody,and 1 case of anti-E alloantibody.After used the corresponding transfusion strategy,only 2 pediatric patients had ineffective transfusion,and the other pediatric patients had good transfusion results.Conclusion There are many reasons for incompatible cross-matching in pediatric patients.ABO hemolytic disease and AIHA are the main reasons for incompatible cross-matching in newborn and non-newborn respectively.

关 键 词：输血 疑难配血 儿童 输血对策 

分 类 号：R446.61[医药卫生—诊断学]