24例输血相关性急性肺损伤病例报告的分析

目的分析国内文献中输血相关性急性肺损伤(transfusion-related acute lung injury,TRALI)的病例报告,为TRALI的预防及临床诊治提供参考。方法结合计算机检索与手工检索收集我国TRALI的病例报告资料,从中提取病例的受者信息和供者信息并进行统计分析。结果共纳入24例TRALI病例;16例好转或痊愈,9例死亡,病死率为37.5%。输血原因有创伤性输血(66.7%)和非创伤性输血(33.3%);输入全血、红细胞悬液、血浆等5种血液制品;提供者信息12例,其中经产妇6例;对供者进行HLA抗体检测3例。结论提高临床对TRALI的认识和重视程度,合理选择血液制品,完善输血前的供受者抗体检测体系,是降低TRALI发生率和病死率的有效措施。

Analysis of 24 Cases with Transfusion-related Acute Lung Injury in Chinese Literatures

Objective To analyse transfusion-related acute lung injury cases in Chinese literatures, and to provide useful information for preventing and diagnosing TRALI. Methods Both electronic and manual retrieval system were used to search the Chinese literatures for cases of TRALI. The clinical information for patient and donor of each case were recorded and analyzed. Results A total of 24 cases were included in this study, of which, 16 recovered and 9 died, the mortality rate was 37.5%. There were two reasons for transfusion, hurt （66.7%） and non-hurt （33.3%）. There were five blood products in this study, whole blood, RBC, plasma,and so on. Donor information were collected from 12 cases, of which, 50% donors were female who had more than 2 pregnancies. Only 3 of all 24 cases had tested anti HLA for donor. Conclusions It was useful to reduce incidence rate and mortality rate of TRALI, which included knowing more well on TRALI, choosing blood products properly, and testing antibody for donor-receiver before transfusion.