基层医院疑难配血原因分析及解决方法

目的探讨基层医院疑难配血原因及解决方法，为临床安全有效用血提供指导。方法分析回顾近三年来柳州市、县9家医院因各种原因配血疑难，而送本中心输血研究室进行疑难配血51例样本的输血前检查及配血记录。结果51例样本中，因血型鉴定困难导致配血疑难3例，占5．9％；盐水介质配血不合17例（包括自身冷凝集14例，IgM抗-M1例，串钱状假凝集3例），占33．3％；自身冷凝集合并IgG抗体15例，占29．4％；IgG温抗体14例，占27．5％（其中温自身抗-e抗体1例，其他温抗体13例，其中抗-Ce 1例，抗-Ec 1例，抗-C 1例，抗-E 1例，抗-D 1例）；药物性抗体2例。结论输血前试验发现ABO正反定型不符时，应先进行血型确定，确定血型后输入同型交叉配血相合的血液。在配血试验中，应尽可能检出37℃反应的抗体，排除37℃不反应的抗体对配血的干扰。对有输血史、妊娠史的患者应作抗体筛选，对抗体筛选阳性者应进行抗体鉴定，为患者找到对应抗原阴性交叉配血相合的血液输入。

Studies and solution of difficult blood cross-match cases in hospitals in Liuzhou

Objective To investigate the reasons of the difficult blood cross-match cases so as to make transfusion practice safe. Methods Dates from 51 difficult blood cross-match samples sent from 9 different hospitals in Liuzhou were studied retrospectively.Results Among 51 difficult blood cross-match cases,3 cases (5.9%) were caused by difficult ABO typing; 17cases (33.3%) were caused by uncompatible blood cross-match in saline phase. 15 case (29.4%) were caused by the present of cold-autoantibody and IgG antibody;...