引用本文:韦亮英,黎海澜,罗瑞献,莫柱宁,朱春丽,阳子骥.交叉配血不合170例原因分析及临床输血策略[J].中国临床新医学,2017,10(8):726-729.
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交叉配血不合170例原因分析及临床输血策略
韦亮英,黎海澜,罗瑞献,莫柱宁,朱春丽,阳子骥
545007 广西,柳州市潭中人民医院检验科(韦亮英);530021 南宁,广西壮族自治区人民医院输血科(黎海澜,罗瑞献,莫柱宁,朱春丽,阳子骥)
摘要:
[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。
关键词:  交叉配血不合  不规则抗体  自身抗体  ABO亚型  输血策略
DOI:10.3969/j.issn.1674-3806.2017.08.04
分类号:R 457.1
基金项目:广西卫计委科研课题(编号:Z2012304)
Analysis of 170 cases with cross-matching incompatibility and the strategy of blood transfusion
WEI Liang-ying, LI Hai-lan, LUO Rui-xian, et al.
Analysis of 170 cases with cross-matching incompatibility and the strategy of blood transfusion
Abstract:
[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.
Key words:  Cross-matching incompatibility  Irregular antibodies  Auto-antibodies  ABO subtype  Blood transfusion strategy