某三甲医院2016—2023年临床输血不良反应分析  

Analysis of clinical adverse transfusion reactions from 2016 to 2023 in a Grade-A tertiary hospital

作　　者：刘雅欣 富文达 王文婷 赵娜娜 李颖 杨龙飞 LIU Yaxin;FU Wenda;WANG Wenting;ZHAO Na'na;LI Ying;YANG Longfei(Department of Transfusion Medicine,Tangdu Hospital,Air Force Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学唐都医院输血科,陕西西安710038

出　　处：《空军军医大学学报》2025年第4期540-543,549,共5页Journal of Air Force Medical University

基　　金：国家自然科学基金青年科学基金(81502671);空军军医大学唐都医院青年自主创新科学基金(2023BTDQN023)。

摘　　要：目的探讨输注不同血液成分时患者输血不良反应的发生特点及采取的临床对策。方法收集2016—2023年某三甲医院收治患者的临床资料,分析输血不良反应的发生率和类型、输注的血液制剂种类、发生输血不良反应的科室分布以及治疗措施。结果2016—2023年该院患者发生输血不良反应共计96例,发生率为0.18‰,主要为非溶血性发热反应(0.04‰)与过敏性输血不良反应(0.14‰),血液制剂中悬浮红细胞与普通冰冻血浆引起输血不良反应的概率较大,输血不良反应发生较多的科室为消化科(15.63%)、神经外科(14.58%)、妇科(14.58%)、肿瘤科(12.50%)和骨科(12.50%),发生过敏反应的患者在停止输血后采用地塞米松(25例)、盐酸异丙嗪(3例)、地塞米松联合盐酸异丙嗪(10例)和地塞米松联合氯雷他定(2例)对症治疗;发生非溶血性发热反应的患者在停止输血后采用地塞米松(6例)和地塞米松联合盐酸异丙嗪(1例)对症治疗。结论临床上常见的输血不良反应中过敏反应与非溶血性发热反应为主要类型,在临床输血过程中应当对不同类型的血液制剂和用血科室进行针对性预防,不断提高医务人员对输血不良反应的识别以及上报意识,保障输血治疗过程安全有效。Objective To investigate the characteristics and clinical countermeasures of adverse transfusion reactions in patients with different blood components.Methods Clinical data of patients admitted to a Grade-A tertiary hospital from 2016 to 2023 were collected to analyze the incidence and types of adverse transfusion reactions,types of transfused blood preparations,distribution of departments where adverse transfusion reactions occurred,and treatment measures.Results A total of 96 patients in the hospital had adverse transfusion reactions from 2016 to 2023,with an incidence of 0.18‰,mainly febrile non-hemolytic transfusion reactions(0.04‰)and allergic transfusion reactions(0.14‰).The probability of adverse transfusion reactions caused by suspended red blood cells and common frozen plasma in blood preparations was relatively high.The departments with the most adverse transfusion reactions were gastroenterology(15.63%),neurosurgery(14.58%),gynecology(14.58%),oncology(12.50%)and orthopedics(12.50%).The patients with allergic reactions were treated with dexamethasone(25 cases),promethazine hydrochloride(3 cases),dexamethasone combined with promethazine hydrochloride(10 cases)and dexamethasone combined with loratadine(2 cases)after stopping blood transfusion.Patients with febrile non-hemolytic transfusion reactions were treated with dexamethasone(6 cases)and dexamethasone combined with promethazine hydrochloride(1 case)after stopping blood transfusion.Conclusion Allergic reactions and febrile non-hemolytic transfusion reactions are the main types of common adverse transfusion reactions in clinical practice.In the process of clinical blood transfusion,targeted prevention should be carried out for different types of blood preparations and clinical blood departments,and the awareness of medical personnel to identify and report adverse reactions of blood transfusion should be continuously improved to ensure the safety and effectiveness of the transfusion treatment process.

关 键 词：输血不良反应 过敏反应 非溶血性发热反应 对症治疗 

分 类 号：R457.1[医药卫生—治疗学]