郑州地区183例临床输血不良反应回顾性分析

目的 分析本地区不同血液制品的输血不良反应发生率的情况，为血站采用血液制品精细化管理来有效预防输血不良反应提供理论依据。方法 统计2017年1~12月河南省红十字血液中心发放至郑州市签订供血合同医院的各类血液制品，收集并查阅同期医院反馈的183例临床输血反应反馈单，记录血液制品种类和输血不良反应类型，比较不同血液制品不良反应的发生率，统计分析不同血液制品引起输血不良反应类型的差异。结果 2017年1~12月共发放血液制品751 490袋，发生输血反应183例，输血不良反应总发生率0.024%（183/751 490），其中全血、悬浮红细胞、去白悬浮红细胞、普通冰冻血浆和病毒灭活血浆的不良反应发生率分别为1.869%（2/107）、0.052%（89/172 366）、0.024%（15/62 247）、0.030%（47/155 337）和0.005%（7/147 460）。输血不良反应以过敏和发热为主，过敏的患者中，由普通冰冻血浆引起的输血反应38例（40.43%）高于病毒灭活血浆6例（6.38%），差异有统计学意义（P<0.05）；发热的患者中，由悬浮红细胞引起的输血反应54例（75.00%）高于去白悬浮红细胞6例（8.33%），差异有统计学意义（P<0.05）。结论 全血的输血不良反应发生率最高，其次为悬浮红细胞和普通冰冻血浆；去白悬浮红细胞和病毒灭活血浆可以显著减少输血不良反应的发生率。

Retrospective analysis of 183 cases of transfusion reactions in Zhengzhou

Objective To analyze the incidence of transfusion reactions in this area, and to provide theoretical basis for blood stations to adopt fine management of blood products to effectively prevent transfusion reactions. Methods Statistical data of various blood products distributed by Henan Red Cross Blood Center to Zhengzhou from January to December 2017 were collected and 183 clinical blood transfusion feedback sheets were consulted. The types of blood products and the types of transfusion reactions to blood transfusion were recorded. The incidence of transfusion reactions to different blood products was compared. Statistical analysis was made on blood transfusion caused by different blood products. Differences in types of transfusion reactions were statistically analysed. Results A total of 751 490 of blood products were distributed from January to December 2017. There were 183 cases of transfusion reactions. The total incidence of transfusion reactions was 0.024% (183/751 490). The incidence of transfusion reactions in whole blood, red blood cells, leukocytes reduced red blood cells, frozen plasma and frozen plasma methylene blue treated and removed was 1.869% (2/107), 0.052% (89/172 366), 0.024% (15/62 247) and 0.030% (47/155 337) and 0.005% (7/147 460), respectively. The main transfusion reactions were allergy and fever. Among the allergic patients, 38 (40.43%) had transfusion reactions caused by frozen plasma, which was higher than 6 (6.38%) by frozen plasma methylene blue treated and removed (P<0.05). Among the patients with fever, 54 (75.00%) had transfusion reactions caused by red blood cells in additive solution, which was higher than 6 (8.33%) by leukocytes-reduced red blood cells (P<0.05). Conclusion The incidence of transfusion reactions of whole blood is the highest, followed by red blood cells and frozen plasma. Leukocytes reduced red blood cells and frozen plasma methylene blue treated and removed can significantly reduce the incidence of transfusion reactions.