摘要
目的:总结分析输血前交叉配血试验微柱凝胶法次侧凝集产生的原因以及临床实际工作中的应用价值,为临床输血的安全性提供有意义的保障。方法:统计分析2018年1月~2020年9月我院输血患者所做的交叉配血试验微柱凝胶法,按照疾病分组,统计分析患者的输血次数、次侧配血凝集发生比率、输血不良反应发生比率,分析它们之间的相关性;并运用抗体筛选鉴定试验、抗人球蛋白试验、放散试验、血常规检测红细胞分布宽度、显微镜检查红细胞形态结构等实验手段和方法,研究交叉配血试验微柱凝胶法次侧凝集产生的原因以及临床意义。结果:分析交叉配血试验微柱凝胶法28816人次,其中次侧配血凝集231人次,凝集率为0.8%;次侧凝集的产生,集中发生的主要的疾病为肿瘤血液系统疾病、ICU重症及急症病人、外伤、肝病患者、肾病患者、病人终末期恶病质等;肿瘤血液系统疾病患者次侧配血发生的凝集率与输血的次数、输血反应发生比率、输血的效果呈正相关(P<0.05);ICU重症、急症病人、外伤、肝病患者、肾病患者、病人终末期患者与输血的次数、输血反应的发生率、输血的效果无相关性(P>0.05);次侧配血凝集发生的原因主要有:患者红细胞形态结构发生变化以及细胞膜的变化、血浆蛋白因素的影响、献血者的血浆中存在同种抗体、错误标本、标本抗凝不合适、红细胞未充分洗涤、其它原因等;对于免疫因素以及非免疫因素导致的次侧配血凝集的原因进行分类比较研究,证实其差异有统计学意义(P<0.05)。结论:引起交叉配血微柱凝胶卡式法次侧凝集的原因众多,由非免疫因素所导致的交叉配血微柱凝胶卡式法次侧凝集发生的比率较高、输血反应率和输注无效率较低;而免疫因素导致的交叉配血微柱凝胶法次侧凝集发生的比率较低、但输注无效率较高,而且引起输�
Objective:To analyse the secondary agghlination reasons for the cros matching by Microcolumn Gel Test,to providereference or the safety of dinical blood transfusion.Methods:Cases of patients with the secondary agglulination for the cross matching werechosen from January 2018 to Septermber 2020 in our hospital analyseing to the diferent disease group,to evaltate the relation of the numbersof blood trastusion,the reltion of the proportion of secondary agglutlination for the cross matching,the relation of the blood transtusionreaction.To analyze the reasons of the secondary agglulination for the cross matching by the antibodies identification,antiglobulin test,andthe morphology of red blood c ell,Investigated the significance of blood transtusion Results:28816 cases were analyzed by the crossmatching with microcolumn gel test,there were 231 cases secondary agghutlination,the agglulination rate 0.8%.The patients with secondaryaggltlination by cross matching mainly included cancer patiens,hemopathy patiens,ICU critical patient,liver disease patients,nephroticpatients trauma patients,end stage patients.The aggulination rates of cancer patiens and the hemopathy patient associated with thefrequency of blood transfusions,there were positive correlation between the frequency of blood transtusion,adverse reactions of bloodtransftsion,and the effect of blood transtsion(P<0.05),but there were irrelevant between the frequency of blood transtsion,adversereactions ofblood transfuion,and the effect of blood transtusion for the lCU critical patients,liver disease patient,nephrotic patients,traumapatients,and the end stage patients(P>0.05).The reasons of the secondary agglulination by microcolumn gel test of Cross matching mainlyincluded the changes of the red blood cell structure,the influence of plasmas proteinsthe existence of alloantibodies from donorerroneoussample,the improper blood anticoagulation,insufficient washing cell,and so on.The difference was statistically significant between the casescaused by immune and non inmmun
作者
王桂娟
WANG Gui-juan(Department of Blood Transfusion,Taian Hospital of traditional Chinese Medicine Taian City,Shandong Province,Shandong Taian 271000)
出处
《医学检验与临床》
2020年第11期35-38,23,共5页
Medical Laboratory Science and Clinics
关键词
交叉配血
微柱凝胶卡式法
次侧凝集
原因分析
临床意义
Cross matching
Microcolumn gel method
Secondary agglulination
Cause analysis
Clinical significance
