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目的全面了解该院7年来输血不良反应的发生情况,并分析其分布特点和可能的相关性因素,为深入研究输血不良反应的发生机制提供参考。方法通过手工查阅2010年以来所有输血不良反应的相关记录信息,通过电子病历的输血管理系统查阅2013年来所有悬浮红细胞的有效期和发血日期。结果 2010年以来,从该院输血不良反应发生率来看,总体发生率为2.38±0.86‰(349次/151 605 U),血小板为5.64‰,红细胞为3.17‰,血浆为1.28‰,冷沉淀为0.94‰。在非溶血性发热反应中RBC占64%(172/212);过敏反应中血浆占38.1%(40/105),血小板占28.6%(30/105)。消化内科和血液内科分别占输血反应总数的32%和21%(110/349和72/349);消化道出血患者发生的不良反应中RBC占93%(63/68);肝病患者发生的不良反应中血浆占71%(17/24);白血病患者发生的不良反应中血小板占57%(20/35)。储存期为第1、2、3和第4周的悬浮RBC不良反应发生率分别为5.66‰、4.49‰、3.65‰和4.89‰。结论 RBC发生的输血不良反应以非溶血性发热为主,其他血液成分以过敏反应为主;随着悬浮RBC储存时间的延长,其输血不良反应的发生率出现先降低后升高的趋势。本研究不能完全排除疾病类型和相关血液成分之间发生特定输血不良反应的相关性。
Objective To comprehensively understand the incidence of adverse reactions of blood transfusion in this hospital over the past 7 years and to analyze its distribution characteristics and possible related factors so as to provide reference for further study on the pathogenesis of adverse reactions of blood transfusion. Methods The records of all transfusions related to adverse reactions of blood transfusions were recorded by hand and the expiration dates and the dates of blood transfusions of all resuscitated erythrocytes in 2013 were obtained through the transfusion management system of electronic medical records. Results From 2010, the overall incidence of adverse reactions in this hospital was 2.38 ± 0.86 ‰ (349 times / 151 605 U), platelet count was 5.64 ‰, erythrocytes was 3.17 ‰, plasma was 1.28 ‰, and cryoprecipitate 0.94 ‰. RBC accounted for 64% (172/212) of non-hemolytic febrile reactions; plasma (38.1% (40/105)) and platelets (28.6% (30/105)) in anaphylaxis. Gastroenterology and hematology accounted for 32% and 21% (110/349 and 72/349) of the total number of transfusion reactions, respectively; 93% (63/68) of the RBCs were adverse reactions in patients with gastrointestinal hemorrhage; and those with liver disease Reactions accounted for 71% of the plasma (17/24); platelets accounted for 57% (20/35) of the adverse reactions in leukemia patients. The incidences of adverse reactions of RBCs were 5.66 ‰, 4.49 ‰, 3.65 ‰ and 4.89 ‰, respectively, at the first, second, third and fourth weeks of storage. Conclusions The adverse reactions of blood transfusion in RBC are dominated by non-hemolytic fever. Other blood components are mainly anaphylactic reactions. With the prolongation of storage time of RBCs, the incidence of adverse reactions of blood transfusion first decreased and then increased. This study does not completely exclude the association between the type of disease and the specific blood transfusion adverse events that occur in the relevant blood components.