血液性疾病疑难性交叉配血分析
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摘要
目的探讨血液性疾病疑难交叉配血不合原因,提出解决对策,为提高疑难配血处理能力提供依据参考。方法方便选取2014年5月—2018年9月该院72例有输血指征的血液性疾病患者为研究对象,全部入选病例交叉配血试验均提示配血不合,回顾性分析患者配血试验结果以及抗体筛选与鉴定结果,查找配血不合原因。结果盐水法交叉配血不合45例(62.50%),以缗钱状凝集构成比最高(51.11%),自身温抗体次之(17.78%);凝聚胺法交叉配血不合6例(8.33%);抗人球法交叉配血不合18例(25.0%),血清中均含IgG抗体,以抗-E构成比最高(50.0%);盐水法与抗人球法交叉配血均不合2例(2.78%),均为自身免疫性溶血性贫血。结论由于血液性疾病自身特性,患者同型输血也存在交叉配血不合的问题,为降低或消除输血不良反应,临床应积极根据患者病因去除配血不利影响因素,以更好的保障输血疗效及安全。
Objective To investigate the causes of mismatched blood matching in blood diseases, and to propose solutions to provide reference for improving the ability of difficult blood matching treatment. Methods From May 2014 to September2018, 72 patients with blood diseases with blood transfusion indications in our hospital were conveniently selected as subjects. All the matched cases of blood matching tests indicated that the blood was not matched. The results of the blood test,antibody screening and identification results were retrospectively analyzed to find the cause of mismatching. Results There were 45 cases(62.50%) of the cross-matching blood in the saline method. The highest ratio of agglomeration was observed(51.11%), followed by self-warming antibody(17.78%). The condensed amine method was not suitable for 6 cases(8.33%).The anti-human ball method did not match 18 cases(25.0%), and the serum contained IgG antibody, which had the highest anti-E ratio(50.0%); the salt method and the anti-human ball method did not match 2 cases(2.78%), all of which are autoimmune hemolytic anemia. Conclusion Due to the characteristics of blood diseases, patients with homologous blood transfusion also have cross-matching problems. In order to reduce or eliminate adverse reactions of blood transfusion, clinically,the adverse factors of blood matching should be removed according to the cause of the patients, so as to better ensure the efficacy and safety of blood transfusion.
Objective To investigate the causes of mismatched blood matching in blood diseases, and to propose solutions to provide reference for improving the ability of difficult blood matching treatment. Methods From May 2014 to September2018, 72 patients with blood diseases with blood transfusion indications in our hospital were conveniently selected as subjects. All the matched cases of blood matching tests indicated that the blood was not matched. The results of the blood test,antibody screening and identification results were retrospectively analyzed to find the cause of mismatching. Results There were 45 cases(62.50%) of the cross-matching blood in the saline method. The highest ratio of agglomeration was observed(51.11%), followed by self-warming antibody(17.78%). The condensed amine method was not suitable for 6 cases(8.33%).The anti-human ball method did not match 18 cases(25.0%), and the serum contained IgG antibody, which had the highest anti-E ratio(50.0%); the salt method and the anti-human ball method did not match 2 cases(2.78%), all of which are autoimmune hemolytic anemia. Conclusion Due to the characteristics of blood diseases, patients with homologous blood transfusion also have cross-matching problems. In order to reduce or eliminate adverse reactions of blood transfusion, clinically,the adverse factors of blood matching should be removed according to the cause of the patients, so as to better ensure the efficacy and safety of blood transfusion.
引文
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[10]张伟军,王杰敏,胡少媚.盐水介质法、凝聚胺法、微柱凝胶法3种交叉配血法在新生儿输血安全中的应用价值研究[J].黑龙江医学,2016,40(2):124-125.
[2]杜海林.抗-E合并抗-Fya抗体致疑难配血的试验和分析[J]临床血液学杂志:输血与检验,2018,31(5):813-814.
[3]张勇萍,崔颖,安宁,等.抗人球蛋白试验在疑难交叉配血中的应用价值分析[J].细胞与分子免疫学杂志,2018,34(5)452-455.
[4]王鹤,章旭.红细胞血型基因分型技术在疑难配血中的应用[J].临床输血与检验,2018,20(2):189-190.
[5]刘潘,夏琳.凝聚胺法与微柱凝胶法交叉配血阳性结果分析[J].临床血液学杂志:输血与检验,2017,30(4):631-633.
[6]陆乐,吴玲玲,姚晓娟,等.直接抗人球蛋白试验阳性病人ABO、Rh疑难血型鉴定和交叉配血试验74例分析[J].安徽医药,2017,21(2):277-280.
[7]刘飒爽,王小伟,陈宇锋.20例疑难配血原因分析及其输血处理[J].深圳中西医结合杂志,2018,28(7):112-113.
[8]胡劲辉,肖庆,王艳春,等.临床疑难配血相关因素分析与应对措施探讨[J].检验医学与临床,2017,14(Z1):46-47.
[9]Suen Sze-chuan,Goldhaber-Fiebert Jeremy D.Matching Mic rosimulation Risk Factor Correlations to Cross-sectional Data:The Shortest Distance Method[J].Medical Decision Making,2018,38(4):452-464.
[10]张伟军,王杰敏,胡少媚.盐水介质法、凝聚胺法、微柱凝胶法3种交叉配血法在新生儿输血安全中的应用价值研究[J].黑龙江医学,2016,40(2):124-125.
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