反复输血患儿红细胞Rh表型检测及同型输注的必要性探讨  

Detection of Rh Phenotype of Red Blood Cells in Children with Repeated Blood Transfusion and the Necessity of Isotype Transfusion

作　　者：王静 刘溢香 谢惠宇 张洪为 黄远帅 王华 Wang Jing;Liu Yixiang;Xie Huiyu(Department of Blood Transfusion,The Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000;Southwest Medical University,Luzhou,Sichuan 646000)

机构地区：[1]西南医科大学附属医院输血科,四川泸州646000 [2]西南医科大学,四川泸州646000

出　　处：《四川医学》2022年第11期1120-1123,共4页Sichuan Medical Journal

摘　　要：目的探讨反复输血患儿红细胞Rh表型检测及同型输注的必要性。方法对本院儿科194例反复输血患儿采用微柱凝胶法检测ABO和Rh血型系统表型(DEeCc),并随机分为Rh同型输血组和随机输血组,Rh同型输血组持续进行ABO、RhDCcEe抗原相合性输血,随机输血组仅进行ABO、RhD抗原相合性输血。在随后的每次输血前进行Rh表型复查、抗体筛查、直接抗人球蛋白试验(DAT)并与第一次检测结果比较。统计分析两组输血后情况(包括不规则抗体产生率、输血不良反应发生率及Hb的提升情况)。结果本研究Rh表型及抗原分布情况与其他地区相似。微柱凝胶卡复查Rh表型同型输血组结果清晰,无混合视野,随机输血组出现混合视野,结果判定困难。随机输血组Rh系统不规则抗体产生率、DAT阳性率分别为10.31%和8.25%,远高于同型输血组的0和1.03%;输血不良反应随机输血组7例,同型输血组1例。两组不规则抗体产生率、输血不良反应发生率以及Hb提升情况差异均有统计学意义(P<0.05)。结论反复输血患儿在首次输血时即进行Rh表型检测并持续同型输血,可避免因随机输血造成的Rh表型鉴定及交叉配血困难,并可有效减少儿童输血免疫的风险以及输血不良反应的发生。Objective To explore the necessity of Rh phenotype detection and homologous transfusion of red blood cells in children with repeated blood transfusion.Methods ABO and Rh blood group system phenotypes(DEeCc)were detected by micro-column gel method in 194 children with repeated blood transfusion in the Department of Pediatrics of our hospital,and they were randomly divided into Rh isotype blood transfusion group and random blood transfusion group.The Rh homologous blood transfusion group received continuous ABO and RhDCcEe antigen-compatible blood transfusion,and the random blood transfusion group only received ABO and RhD antigen-compatible blood transfusion.Rh phenotype re-examination,antibody screening,and direct anti-human globulin test(DAT)were performed before each subsequent transfusion and compared with the results of the first test.The post-transfusion condition of the two groups was statistically analyzed(including the production rate of irregular antibodies,the incidence of adverse blood transfusion reactions and the increase in Hb).Results The Rh phenotype and antigen distribution in this project were similar to those in other regions.The results of the Rh phenotype isotype blood transfusion group were clear after the micro-column gel card review,and there was no mixed field of vision.The random blood transfusion group had mixed field of vision,and the result was difficult to judge.The Rh system irregular antibody production rate and DAT positive rate of the random blood transfusion group were 10.31%and 8.25%,respectively,which were much higher than the corresponding rate of the same type blood transfusion group(0 and 1.03%,respectively).Adverse blood transfusion reactions were as follow:5 cases were randomized in the blood transfusion group,and 1 case was in the isotype blood transfusion group.There were statistically significant differences in the production rate of irregular antibodies,the incidence of adverse blood transfusion reactions,and the increase in Hb between the two groups(P<0.05).Conclusio

关 键 词：反复输血 儿童 Rh表型 同型输血 

分 类 号：R457.1[医药卫生—治疗学]