ABO同型交叉配血不合原因及应对措施

目的：近年来,因ABO同型交叉配血不合的病例在临床输血工作中时有发生,稍有不慎便有可能带来灾难性的后果。作者通过自身所遇到的病例并结合相关文献资料,对引起ABO同型交叉配血不合的原因进行分析并提出解决方案。方法：使用凝聚胺配血法和卡式配血法。结果：在对1例临床病人常规合血过程中,经凝聚胺和卡式配血法进行严格操作,出现主侧凝集,配血不合。病历显示病人有反复输血史,通过不完全抗体检测,发现病人血清中有抗-E产生,通过调换同型血液后配血成功。结论：多次输血可产生不完全抗体,引起输血不合,遇有AB0同型交叉不合病例,应首先检查血型是否正确,有无输血史,利用筛查试剂检查不完全抗体,有条件的实验室应将预约病人的不完全抗体筛查列入常规工作,提前为将要输血的病人作好准备,避免在合血过程中发现问题后再找原因而浪费时间。如自身无法作详细的血型检查的,应及时将标本送血液中心请求帮助。

On Factors of ABO--based Cross Matching Incompatibility and Countermeasures

Objective.. To analyze the factors causing Ate-based cross matching incompatibility and suggest solutions. Methods： Using polybrene and the gel system. Results： One patient with routine operations appeared with non-blood. There were repeated histories of blood transfusion. After incomplete anti-body tests, we found that there was anti-E generated in patients. Through exchange with the same type blood, the blood experiment got success. Conclusion.. Repeated blood transfusion can produce incomplete antibodies. When encountered with cases of the ABO-same type cross matching incompatibility, we should first check the blood type, the blood transfusion history and test incomplete antibody. Laboratory conditions should be the patient＇s incomplete antibody screening is fully included in routine work. Give patients to a good prepare before blood transfusion.