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目的分析新疆地区特殊情况紧急抢救用血情况及其RhD(-)红细胞应急保障供应的特点。方法收集兰州军区乌鲁木齐总医院2013年1月-2015年12月的RhD(-)患者紧急抢救用血病例75例,回顾性统计分析紧急情况下的同型输注RhD(-)红细胞的输血适应证和用量、同型输注RhD(-)红细胞来源、RhD(-)红细胞相容性输注以及RhD(-)抢救用血患者的ABO血型分布情况。结果本组紧急抢救RhD(-)患者中红细胞同型输注者的比例为90.7%(68/75),其中外伤患者占51.5%(35/68)、用血量(5.1±1.6)U/人,妊娠出血患者占32.4%(22/68)、用血量(2.6±0.9)U/人(P<0.05);紧急抢救需要的RhD(-)用血来源依次是库存红细胞,占56.1%(141/251.5),外调红细胞和应急采血分别为21.3%(53.5/251.5)和19.5%(49/251.5);但是在临床红细胞用量较大的2014年,外调红细胞和应急采血所占比例较高,而且出现了明显的O型偏型;在此期间按照《特殊情况紧急抢救输血推荐方案》(简称《紧急输血方案》),对7名严重突发事件致外伤出血患者的紧急抢救输血采取相容性输注,共输O型红细胞15(2.4±0.8)U/人,效果良好。结论新疆地区特殊情况抢救用血保障有明显的地域特征,《紧急输血方案》是临床用血科学、有效的保障。
Objective To analyze the situation of emergency rescue blood supply in Xinjiang and its RhD (-) erythrocyte emergency supply. Methods A total of 75 cases of RhD (-) patients with emergency rescue blood collected from January 2013 to December 2015 in Urumqi General Hospital of Lanzhou Military Region were enrolled in this study. Retrospective statistical analysis of transfusion indications of RhD (-) erythrocytes in emergency And dosage, RhD (-) erythroid origin, RhD (-) red blood cell compatible infusion, and RhD (-) rescue blood. Results The ratio of erythrocyte homozygote in emergency rescue RhD (-) patients was 90.7% (68/75) in this group, including 51.5% (35/68) in traumatic patients and 5.1 ± 1.6 U / person (22/68), and blood (2.6 ± 0.9) U / person (P <0.05). RhD (-) sources for emergency rescue were followed by stored red blood cells (56.1%) 141 / 251.5). The number of RBCs and emergency blood sampling was 21.3% (53.5 / 251.5) and 19.5% (49 / 251.5) respectively. However, in the year of 2014, there was a high proportion of RBCs and emergency blood sampling, But also a significant O-type bias; during this period in accordance with the “special case of emergency rescue blood transfusion recommendations” (referred to as “emergency transfusion program”), seven serious emergency accident-induced bleeding in patients with emergency rescue transfusion to take compatible Sex infusion, a total of O-type red blood cells 15 (2.4 ± 0.8) U / person, the effect is good. Conclusion There are obvious regional characteristics of rescue blood use in special circumstances in Xinjiang. “Emergency blood transfusion program” is a clinically effective and safe blood science.