直接Coombs阳性患者输注悬浮红细胞和洗涤红细胞疗效分析  

Efficacy analysis of transfusion of suspended RBCs and washed RBCs in patients with positive direct Coombs testing results

作　　者：阙文君 赵迪 余泽波[1] 杨晓亮[1] QUE Wenjun;ZHAO Di;YU Zebo;YANG Xiaoliang(Department of Transfusion,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院输血科,重庆400016

出　　处：《中国输血杂志》2022年第4期412-415,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探究直接抗球蛋白试验阳性患者输注悬浮红细胞和洗涤红细胞的有效性和安全性。方法回顾性分析重庆医科大学附属第一医院2015年1月~2020年12月直接抗球蛋白试验阳性凝集强度为2+及以下的患者98例,其中2015年1月~2016年12月31名患者输注洗涤红细胞,设为对照组;2017年1月~2020年12月67名患者输注悬浮红细胞,设为实验组。分别比较2组输注红细胞2 U、4 U前后主要实验室指标变化和输血反应发生情况,评估输注有效性和安全性。结果输注2U后,Hb(g/L)变化:对照组升高12±4.967,实验组升高12.85±7.109,均输注有效且2组间Hb变化无统计学意义(P>0.05);输注4U后,Hb在对照组升高23.78±12.736,实验组升高22.68±9.832,均输注有效且2组间Hb变化无统计学意义(P>0.05)。2组患者输注2U、4U红细胞后,TBIL、IBIL以及LDH较输注前均无明显变化(P>0.05)。2组输血反应发生率差异无统计学意义(P>0.05)。结论直接抗球蛋白试验阳性凝集强度2+及以下的患者,输注悬浮红细胞是安全有效的,无须输注洗涤红细胞。Objective To compare the efficacy and safety of transfusion of suspended RBCs and washed RBCs in patients with positive direct Coombs testing results.Methods A retrospective analysis was conducted on 98 patients with positive direct Coombs testing results as 2+or less in the First Affiliated Hospital of Chongqing Medical University from January 2015 to December 2020.Among them,31 patients,from January 2015 to December 2016,were transfused with washed RBCs and set as the control group;the other 67 patients,from January 2017 to December 2020,transfused with suspended RBCs,were enrolled as the experimental group.The changes of main laboratory indexes and the incidence of transfusion adverse reactions before and after transfusion of 2 U and 4 U RBCs were compared between the two groups to evaluate the efficacy and safety of transfusion.Results After 2 U and 4 U transfusion,Hb increased by 12±4.967(g/L)and 23.78±12.736(g/L)in the control group,while 12.85±7.109(g/L)and 22.68±9.832(g/L)in the experimental group,All transfusions of the two groups were effective,and no significant differences in Hb,TBIL,IBIL and LDH were noticed by groups(P>0.05).No significant difference in the incidence of adverse reactions to blood transfusion between the 2 groups was observed(P>0.05).Conclusion The transfusion of suspended RBCs is safe and effective in patients with positive direct Coombs testing results as 2+or less,and the transfusion of washed RBCs was unnecessary.

关 键 词：直接抗球蛋白试验 洗涤红细胞 悬浮红细胞 

分 类 号：R457.1[医药卫生—治疗学]