疑难交叉配血成因与交叉配血策略的分析  

Investigation of 181 cases of difficult blood matching and analysis of the corresponding matching strategies

作　　者：刘英[1] 王峻 葛艳玲[1] LIU Ying;WANG Jun;GE Yanling(Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院输血科,北京100035

出　　处：《中国输血杂志》2020年第2期152-154,共3页Chinese Journal of Blood Transfusion

摘　　要：目的分析引起疑难配血的成因,探讨科学有效的解决方法。方法调查2015年1月-2017年12月的181例疑难配血,结合同时期的8 247例输血前检测试验结果,分析造成疑难配血的主要原因及配血策略探讨。随机抽取307例近期(2周内)在本院有输血史的患者标本进行RhE与RhC血型检测,以分析RhC,RhE盲选情况下的的匹配情况。结果 181例疑难配血中,供血者抗筛阳性4例(抗-E),供血者直抗阳性2例;备血患者抗筛阳性175例,其中自身抗体24例,同种抗体151例(抗-RhE 129例)。8 247例备血患者中RhE阴性4179(50.7%)例,RhE阳性4 068(49.3%)例;RhC阴性975(11.8%)例,RhC阳性7 272(88.2%)例;近期(2周内)在本院输过血的备血患者307例中,双群162例(52.8%),其中RhE血型双群121例(121/162),RhC血型双群42例(42/162),RhC和RhE同时双群1例。结论 Rh血型同种抗体是造成疑难配血的主要原因。ABO血型和Rh(C.c.D.E.e)血型同型输血同型输血,可以最大程度降低疑难配血的发生率。Objective To analyze the causes of difficult blood matching and to propose viable identification methods to solve the problems.Methods 181 cases of difficult blood matching between January 2015 and December 2017, combined with the results of 8 247 cases of pre-transfusion test, were analyzed to study the main causes of difficult blood matching and corresponding strategies. A total of 307 patients with recent history of blood transfusion in our hospital(within two weeks) were randomly selected for RhE and RhC blood group detection, in order to determinate the random-donor matching status of RhC and RhE.Results Among the 181 cases of difficult blood matching, irregular antibody positive(anti-RhE specificity) were found in 4 donors, direct Coomb′s test positive in 2 donors, and antibody screening positive in 175 patients, including autoantibodies in 24 and alloantibodies in 151(anti-RhE specificity in 129, with a ration of 129/151). Of the 8 247 patients applying for blood transfusion, RhE negative(50.7%,4 179/8 247), RhE positive(49.3%, 4 068/8 247), RhC negative(11.8%,975/8 247) and RhC positive( 88.2%,7 272/8 247) patients were evaluated. Among the 307 patients who received blood transfusion in our hospital within two weeks, double population(DP) was observed in 162(52.8%) cases, including 121(121/145) cases of DP in anti-E column of micro gel bloodgrouping card, 42(42/145)cases of DP in anti-C column and 1 case of DP both in anti-C and anti-E column.Conclusion Rh blood group alloantibodies are the main cause of difficult blood matching. The same type transfusion of ABO and Rh(C/c/D/E/e) can minimize the incidence of difficult blood matching to the greatest extent.

关 键 词：同种抗体 疑难配血 不规则抗体筛查 

分 类 号：R457.11[医药卫生—治疗学]