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目的观察交叉配血试验不合或/和抗体筛查阳性时紧急抢救输血推荐方案的临床应用及效果分析。方法对输血前交叉配血试验不合或/和抗体筛查阳性且生命危急的患者,启动《推荐方案》中输血方案进行抢救,密切观察患者输血过程中有无输血不良反应发生,比较输血前与输血后1 d、7 d,Hb、Hct、TBIL、DBIL、IBIL的变化,对应用紧急输血方案临床疗效进行评价。结果 10例交叉配血试验不合和抗体筛查阳性患者需抢救输血,男性3例,女性7例,均为Rh(D)阳性患者;其中3名患者输注同型交叉配血阴性供者红细胞;4名患者输注非同型[均为O型Rh(D)阳性]且交叉配血试验阴性的供者红细胞;还有3名患者未筛选出交叉配血试验阴性的血源,为抢救生命应急选择与患者同型且交叉配血试验凝集程度最弱(±或1+)的供者红细胞输注;10名患者中3名非同型输注AB型血浆;10例患者输注后,血红蛋白、红细胞压积明显提高,均无溶血及其它输血不良反应发生。结论交叉配血试验不合或/和抗体筛查阳性患者紧急抢救输血选择与患者ABO血型同型且交叉配血试验阴性的供者红细胞输注、选择O型且交叉配血试验阴性的供者红细胞输注及直接选择AB型血浆输注是安全有效的,应当推广。
Objective To observe the clinical application and effect analysis of emergency rescue blood transfusion plan when cross matching blood test failed or / and antibody screening positive. Methods Patients with positive cross-matching blood test and / or antibody screening positive life-threatening before blood transfusion were started to rescue the blood transfusion program in “recommended protocol” and closely observed whether transfusion adverse reactions occurred in the transfusion process. The changes of Hb, Hct, TBIL, DBIL and IBIL at 1 d, 7 d after blood transfusion were evaluated with the clinical efficacy of emergency transfusion protocol. Results 10 cases of cross-matching blood tests and antibody screening positive patients need rescue blood transfusions, 3 males and 7 females, all Rh (D) -positive patients; 3 patients were transfused with the same-type cross-matching negative donor erythrocytes; Four patients were infused with non-isotype [both Rh (D) positive] and crossmatched negative donor erythrocytes. Three other patients were not screened for negative blood for cross-matching test, The donor erythrocyte infusion with the weakest (± or 1+) agglutination to the patient’s isotype and crossover test was chosen; 3 non-isotype AB plasma was injected in 10 patients; after transfusion in 10 patients hemoglobin, erythrocyte Pressure product was significantly improved, no hemolysis and other transfusion adverse reactions. Conclusions Cross-matching test and / or antibody screening-positive patients emergency rescue transfusion selection and donor ABO blood type and cross-matching test negative donor red blood cell transfusion, select O-type and cross-matching test negative donor red blood cell transfusion Note and direct choice AB type plasma infusion is safe and effective, it should be promoted.