%0 Journal Article %T 交叉配血不合170例原因分析及临床输血策略 %T Analysis of 170 cases with cross-matching incompatibility and the strategy of blood transfusion %A 韦亮英,黎海澜,罗瑞献,莫柱宁,朱春丽,阳子骥 %A WEI,Liang ying %A LI,Hai lan %A LUO,Rui xian %A et al. %J 中国临床新医学 %J CHINESE JOURNAL OF NEW CLINICAL MEDICINE %@ 1674-3806 %V 10 %N 8 %D 2017 %P 726-729 %K 交叉配血不合;不规则抗体;自身抗体;ABO亚型;输血策略 %K Cross-matching incompatibility;Irregular antibodies;Auto-antibodies;ABO subtype;Blood transfusion strategy %X [摘要] 目的 探讨交叉配血不合原因以及相应的处理方法,以指导临床安全有效合理用血。方法 对2014-01~2016-12在该院收治需行输血治疗的170例交叉配血不合患者进行回顾性分析,总结输血前交叉配血不合原因,归纳处理方法。结果 170例疑难交叉配血标本中,不规则抗体88例(51.76%),自身抗体62例(36.47%),ABO亚型14例(8.24%),蛋白凝集4例(2.35%),药物原因2例(1.18%)。不规则抗体中,Rh系统32例(联合抗体3例),MNSs系统19例,Lewis系统6例,Kidd系统和Diego系统各占1例,多种抗体7例,未能检出抗体特异性16例,抗体阳性未鉴定抗体特异性6例。ABO亚型14例中有稀有血型类孟买3例。采取配合性输注各种血液成分,患者均及时得到有效救治。结论 交叉配血不合主要是由同种不规则抗体,其次是自身抗体等原因引起。根据交叉配血不合的具体原因采取相应措施,指导临床确定输血方案,选择合适的血液进行输注,保障输血的安全有效。 %X [Abstract] Objective To discuss the causes of the cross-matching incompatibility and the relevant managing methods.Methods We retrospectively analyzed the data of 170 patients with cross-matching incompatibility who needed blood transfusion from the blood bank in our hospital from January 2014 to December 2016, and summarized the causes of cross-matching incompatibility before blood transfusion.Results In the 170 patients with cross-matching incompatibility, there were 88 cases with irregular antibody(51.76%), 62 cases with auto-antibodies(36.47%), 14 cases with ABO subtype(8.24%), 4 cases with protein aggregation(2.35%) and 2 cases with drug reason(1.18%). In the cases with irregular antibodies, there were 32 cases with Rh system(including 3 cases with joint antibodies), 19 cases with MNSs system, 6 cases with Lewis system, 1 case with Kidd, 1 case with Diego system, 7 cases with multiple antibodies. 16 cases failed to detect the antibodies, and 6 cases with unidentified antibodies.Conclusion The main cause of cross-matching incompatibility is the same irregular antibodies, followed by autoantibodies. Clinical blood transfusion schemes should be determined by the types and specific causes of the cross-matching incompatibility. %R 10.3969/j.issn.1674-3806.2017.08.04 %U http://www.zglcxyxzz.com/ch/reader/view_abstract.aspx %1 JIS Version 3.0.0