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目的:了解红细胞输注效果不佳的原因,为临床输血效果评价提供参考。方法:对11例红细胞输注效果不佳患者在输血前、输血后第3、7和12天分别进行直接抗球蛋白试验、抗体筛查和血常规检测以及抗体特异性检测。结果:11例红细胞输注效果不佳患者在输血前抗体筛选等检测均为阴性结果,在输血后第7天开始都出现了血红蛋白和红细胞数先升后降的现象,直接抗球蛋白试验试验的结果均为阳性或可疑,抗体筛查在第12天所有患者都出现抗筛阳性或者可疑。结论:11例红细胞输注效果不佳的原因符合“回忆反应”的特征。提示对于有输血史或多次妊娠史的患者,即使抗体筛选等检测结果为阴性,也应考虑“回忆反应”发生的可能,有必要对此类患者输入Rh抗原(D/C/c/E/e)相合的血液,保证临床输血安全有效。
Objective: To understand the reasons for the poor effect of red blood cell transfusion, provide a reference for the clinical evaluation of blood transfusion. Methods: Direct antiglobulin test, antibody screening, routine blood test and antibody specificity test were performed on 11 patients with poor erythrocyte infusion before transfusion and 3, 7 and 12 days after blood transfusion. Results: In 11 patients with poor erythrocyte infusion, the results of antibody screening before transfusion were negative, and hemoglobin and erythrocyte number increased first and then decreased from the 7th day after transfusion. The direct antiglobulin test The results were positive or suspicious, antibody screening on the 12th day in all patients were anti-screening positive or suspicious. CONCLUSION: The reasons for the poor effect of red blood cells infusion in 11 cases are consistent with the characteristics of “memory reaction”. Tip Patients with a history of blood transfusions or multiple pregnancies should consider the possibility of “recall reaction” even if antibody test results are negative. It is necessary to enter Rh antigens (D / C / c / E / e) match the blood to ensure safe and effective clinical transfusion.