某医院临床输血不良反应调查与分析

目的通过对各类成分血液输血反应发生频率和输血反应类型的调查分析,以提高临床医护人员对输血反应的认识和处理能力。方法对某院2005年1月～2010年2月各种成分输血后所发生的输血反应进行回顾分析。结果在139 852单位输血中,共发生输血反应143次,总输血反应率为0.10%,输注全血反应率最高为0.99%,红细胞悬液0.14%,冰冻血浆0.07%,血小板0.05%,滤白红细胞0.01%,自体输血无输血反应。输血单位为1,2,3,4和≥5单位的构成比分别为0.03%、0.06%、0.31%、0.41%和1.12%。血液内科、其他科室与外科患者反应频率的差异有统计学意义(P<0.01)。输血反应表现类型以非溶血性发热反应最多见,占62.94%,其次是过敏反应,占32.16%。结论自体输血和去除白细胞悬浮红细胞输注能有效降低输血反应发生率,对多次输血的患者,应输注去除白细胞悬浮红细胞,以减少输血反应的发生。预防性用药可减少轻度的输血反应。

Analysis of Clinical Transfusion Reactions in One Large Hospital

Objective To investigate and analyze the ratio and type of clinical transfusion reactions in all blood component infusion in a large hospital.Methods All blood transfusion reactions occurred during Jan.2005 to Feb.2010 were analyzed in our hospital.Results In total 139 852 units of all component blood transfusions cases,143 blood transfusion reactions were observed,and the reaction rate was 0.10%,the highest rate of infusion reaction in all kinds of blood components was whole blood and it showed 0.99%,red blood cell suspension showed 0.14%, frozen plasma showed 0.07%,platelets showed 0.05%,while red cell suspension with leucocytes filtering only showed 0.01%,no transfusion reaction was observed in autologous blood transfusion.When considering the blood transfusion times,the transfusion reaction rates of the 1 U,2 U,3 U,4 U and ≥5 U showed 0.03%,0.06%,0.31%,0.41%,and 1.12% respectively.The main transfusion reaction was non-hemolytic reaction which accounted for 62.94%,and the second one was allergic reactions（accounted for 32.16%）.Conclusion Autologous blood transfusion and red blood cells suspension are proved to be more safe blood products in reducing the transfusion reactions,leucocytes filtering red cell suspension is benefit for patient who needs more than 2 U blood transfusion.