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目的了解建立和完善献血前征询体检机制,对高危献血人群主动退出情况,及献血者血液梅毒螺旋体(TP)和艾滋病病毒(HIV)检测的干预效果,从血液采集源头选择低危献血者,保证血液安全。方法选择干预前(2011-2013年)和干预后(2014-2015年3月)浙江省江山市无偿献血者,分团体献血者、个人献血者和互助献血者3组,收集主动退出献血、保密性弃血和献血前梅毒筛查情况资料进行分组比较和统计学分析。结果共计调查19960名无偿献血者,干预前在献血前主动退出献血及保密性弃血者35人,干预后为35人,两组比较差异有统计学意义(χ2=20.72,P<0.01)。2014-2015年3月献血前筛查检出抗-TP阳性35人。干预前检测14 743人,抗-TP阳性率为0.92%(136/14 743),抗-HIV初筛阳性率为0.08%(12/14 743),确诊阳性1例;干预后检测5217人,抗-TP阳性率为0.25%(13/5217),抗-HIV初筛阳性率为0.09%(5/5217),无确诊阳性者;两组抗-TP阳性率比较差异有统计学意义(χ2=23.58,P<0.01),两组抗-HIV初筛阳性率比较差异无统计学意义(χ2=0.09,P>0.05)。干预后团体献血者不合格率与干预前比较差异均有统计学意义(χ2=7.32,P<0.01),互助献血者和个人献血者分别与干预前比较差异均无统计学意义(χ2=1.40、1.64,P>0.05)。结论建立和完善科学合理的献血前征询机制,对献血者主动退出、梅毒阳性检出率及HIV感染确诊率有一定的干预效果。
Objective To understand the mechanism of pre-blood donation consultation and to take the initiative to withdraw from high-risk blood donors and to monitor the effects of HIV and TP on blood donors, to select low-risk blood donors from blood collection sources, Blood safety. Methods Before the intervention (2011-2013) and after intervention (2014-2015), three groups of unpaid blood donors, group donors, individual blood donors and mutual aid blood donors were collected from Jiangshan City, Zhejiang Province. Sex and blood donation before syphilis screening data were grouped and statistical analysis. Results A total of 19960 volunteer blood donors were surveyed. Before the intervention, 35 blood donors and confidential blood donors voluntarily withdrew their blood donation before the donation, 35 after intervention. There was significant difference between the two groups (χ2 = 20.72, P <0.01). From March 2014 to March 2015, pre-blood donation screening detected anti-TP positive 35 people. 14 743 were detected before intervention, the positive rate of anti-TP was 0.92% (136/14 743), the positive rate of anti-HIV screening was 0.08% (12/14 743) The positive rate of anti-TP was 0.25% (13/5217), the positive rate of anti-HIV screening was 0.09% (5/5217), no positive diagnosis was found. The positive rates of anti-TP in the two groups were statistically significant (χ2 = 23.58, P <0.01). There was no significant difference in the positive rate of anti-HIV screening between the two groups (χ2 = 0.09, P> 0.05). The rate of unqualified group blood donors after intervention was significantly different from that before intervention (χ2 = 7.32, P <0.01). There was no significant difference in blood donors and individual blood donors before intervention (χ2 = 1.40 , 1.64, P> 0.05). Conclusion Establishing and perfecting a scientific and reasonable pre-donation consultation mechanism has some intervention effects on the voluntary withdrawal of blood donors, the positive detection rate of syphilis and the diagnosis rate of HIV infection.