紧急输O型未交叉配血悬浮红细胞现状分析  

Status survey of uncrossmatched type O suspended RBCs in patients with emergency transfusion

作　　者：彭卓越 徐士岚 杨鑫鑫 陈春霞[1] 谭斌[1] PENG Zhuoyue;XU Shilan;YANG Xinxin;CHEN Chunxia;TAN Bin(Department of Blood Transfusion,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院输血科,四川成都610041

出　　处：《中国输血杂志》2025年第1期48-53,共6页Chinese Journal of Blood Transfusion

摘　　要：目的基于“紧急输血由急诊科授权医生启动,输血科15 min内发放不超过4 U O型未交叉配血悬浮红细胞”的单中心临床实践,了解该实践背景下紧急输O型未交叉配血悬浮红细胞策略的实施现状,为血液管理提供参考。方法回顾性分析2019年8月—2024年4月四川大学华西医院紧急输O型血患者病例信息,包括申请紧急输血原因、输血申请送达输血科所需时间、输血科血液发放所需时间、患者输血前后总胆红素、间接胆红素、乳酸脱氢酶、患者血型、病情转归等。结果2019年8月—2024年4月本院申请紧急输O型血的患者有39例,共输注未经交叉配血的O型悬浮红细胞90 U。患者均为Rh(D)阳性,其中A型14例;B型6例;O型16例;AB型2例;暂无法定型1例,抗体筛查阳性2例,紧急输O型血的患者中车祸伤是主要原因,占46%(18/39),死亡率51.28%(20/39),死亡原因均为原发伤,无溶血性输血反应的临床指征:输血前后总胆红素(TBTL)、间接胆红素(IBIL)、乳酸脱氢酶(LDH)无统计学差异,P值均>0.05。患者从入院到输血科接收输血申请单和输血科从收到申请单到血液发放的中位时间分别为30.20 min和5.30 min。结论基于“紧急输血由急诊科授权医生启动,输血科15 min内发放不超过4 U O型未交叉配血悬浮红细胞”的单中心临床实践具有安全性,但申请紧急输O型血流程中在输血申请单送达输血科之前有优化空间。Objective To investigate the implementation of emergency transfusion strategy of uncrossmatched type O suspended RBCs based on the single-center clinical practice,which is"emergency transfusion is initiated by the authorized doctor of the emergency department,and no more than 4 U of type O uncrossmatched suspended RBCs are issued within 15 minutes in the transfusion department"(referred as the Practice),so as to provide reference for blood management.Methods A retrospective analysis of the information of patients who received uncrossmatched type O suspended RBCs in West China Hospital of Sichuan University from August 2019 to April 2024 was conducted.The analysis included reasons for emergency blood transfusion,time of receiving transfusion application and blood distribution,total bilirubin,indirect bilirubin,lactate dehydrogenase before and after transfusion,blood group of patients,and disease outcome.Results From August 2019 to April 2024,39 cases applied for emergency transfusion of type O suspended RBCs,and a total of 90 U uncrossmatched suspended RBCs were transfused.All patients were Rh(D)positive,including 14 cases of blood group A,6 cases of blood group B,16 cases of blood group O,2 cases of blood group AB,one case of undetermined blood group,and 2 cases with positive antibody screening.The main cause of emergency transfusion of type O suspended RBCs was traffic accident,accounting for 46%(18/39),with a mortality rate at 51.28%(20/39).The cause of death was primary injury,and no adverse reactions were reported.There was no significant difference in total bilirubin(TBIL),indirect bilirubin(IBIL)and lactate dehydrogenase(LDH)before and after blood transfusion(P>0.05).The median duration from admission to receiving transfusion application was 30.20 minutes,and 5.30 minutes from receipt of the application to blood distribution.Conclusion The single-center based Practice is safe,but there is room for optimization before the link of blood transfusion application sent to the transfusion department when applying

关 键 词：紧急输血 未交叉配血 O型悬浮红细胞 溶血性输血反应 

分 类 号：R457.1[医药卫生—治疗学]