直接抗人球蛋白试验阳性病人ABO、Rh疑难血型鉴定和交叉配血试验74例分析

目的 总结直接抗人球蛋白试验(直接Coombs试验)阳性病人的ABO、Rh疑难血型鉴定和交叉配血试验的经验.方法选择74例确诊为原发性和继发性自身免疫性溶血性贫血(AIHA)且红细胞直接Coombs试验阳性病人,进行聚凝胺法交叉配血、抗冷体的吸收试验、磷酸氯喹放散试验以及自身抗体吸收试验,用吸收后的血清进行抗体特异性的鉴定.结果 59例病人出现ABO血型正反定型不一致,经磷酸氯喹放散试验和自身抗体吸收试验后正确定型;61例病人出现交叉配血不合,经磷酸氯喹放散试验和自身抗体吸收试验后,50例病人配血相合.结论 运用磷酸氯喹放散试验、冷抗体吸收试验、自身抗体吸收试验,可明显提高病人血型鉴定准确率以及配血的相合率,确保病人安全输血.

ABO and Rh difficult blood group examination and cross match bloodtest in 74 patients positive in direct Coombs test

Objective To summarize the experience in ABO and Rh difficult blood group examination and cross match blood test in 74 patients positive in direct Coombs test.Methods Totally 74 patients who were definitely diagnosed with primary or secondary AIHA and were positive in RBC direct Coombs test were chosen for the cross matching by polybrene method,cold antibody absorption test,chloroquine phosphate elution test,and autoantibody absorption test.Antibody specificity was identified using postabsorptive serum.Results ABO blood group typing inconsistency was present in 59 patients.The blood groups were correctly typed after chloroquine phosphate elution test and autoantibody absorption test.Cross matching incompatibility was present in 61 patients and bloods were compatibly matched in 50 patients after chloroquine phosphate elution test and autoantibody absorption test.Conclusion Chloroquine phosphate elution test,cold antibody absorption test and autoantibody absorption test can significantly elevate the accuracy of blood group examination and compatibility of blood matching to ensure the safety of blood transfusion.