不规则抗体筛查在临床输血中的意义探讨

目的探讨通过抗体筛查和鉴定,发现有临床意义的不规则抗体,以避免不规则抗体引起的溶血性输血反应发生,并选择相合的血液,确保患者输血安全。方法采用微柱凝胶抗人球蛋白法检测978例神经外科择期手术需要输血患者的血清（浆）不规则抗体,结果阳性的标本再送南京市血液中心进行抗体特异性进一步鉴定。对不规则抗体筛查结果进行分析。结果 978例择期手术患者的不规则抗体筛查发现不规则抗体阳性6例,阳性率0.61%。筛检阳性的6例标本经南京市血液中心进行抗体特异性鉴定,发现在6例不规则抗体阳性患者中抗-E 3例、抗-D 1例、抗-cE 2例。对6例不规则抗体阳性患者提示少输或不输血,其中2例未输血,4例输注经南京市血液中心配合型血液,无1例发生溶血性输血反应。结论在输血前对受血者进行不规则抗体筛查可发现有意义的不规则抗体,以及选择和准备相适合的血液,防止溶血性输血反应。这对确保临床输血安全具有重要的意义。

Significance of irregular antibody screening before blood transfusion in clinical blood transfusion

Objective According to the blood transfusion technical specifications,the irregular antibody of serum（plasma）must be screening in the patients with a history of blood transfusion or pregnancy history and short-term demand massive blood transfusion.To explore the clinical significant irregular antibody found by antibody screening and identification,to avoid the occurrence of hemolytic transfusion reaction caused by irregular antibodies,and select suitable blood,guarantee the blood transfusion safety of patients.Methods The irregular antibody of serum（plasma）was detected with micro column gel Coombs test in 978patients with neurosurgery selective operation and need a blood transfusion.The positive specimens were be further antibody specificity identify to Nanjing Blood Center.The results of irregular antibodies screening were analyzed.Results The irregular antibodies screening in 978selective operation patients discovered 6cases of irregular antibodies positive,the positive rate of 0.61%.The six positive specimens were taken identification of antibody specificity by Nanjing Blood Center.It showed that anti-3was 3cases,anti-D 1case,anticE 2cases.The 6cases of irregular antibodies positive were prompted fewer or without blood transfusion.The two cases of them were without blood transfusion.The 4cases were infusion coordination blood by Nanjing Blood Center,no cases had hemolytic transfusion reaction.Conclusion Before blood transfusion,screening the irregular antibody to blood recipients can find significant irregular antibody,and select,prepare suitable blood,prevent hemolytic transfusion reaction.It has important significance to ensure the safety of clinical blood transfusion.