40例ABO血型鉴定出现弱凝集的结果分析及处理

目的分析40例采用玻片凝集法和试管离心法检测ABO血型出现弱凝集的结果分析及处理。方法 40例弱凝集样本分别经37℃水浴10min、9%生理盐水清洗血细胞3次处理,做盐水试管法的正反定型试验,直接抗人球蛋白试验,送输血科进行微柱凝胶法鉴定,不能确定血型者最后送广州市血液中心鉴定。结果 40例ABO血型鉴定出现弱凝集者共有6例出现直接抗人球蛋白试验阳性。进行水浴、生理盐水洗血细胞处理后,弱凝集现象分别减少40%和52%。在35例标本中盐水试管法正反定型鉴定和微柱凝胶法鉴定一致性达到100%,另有5例正反定型不符,微柱凝胶法鉴定亦不能确定血型者,送广州市血液中心鉴定,结果4例为ABO亚型,1例为存在不规则抗体影响。结论鉴定血型时,当发现ABO血型鉴定试验出现弱凝集时,首先应重复做试验一次,严格执行操作规程,使用质量合格的试剂以及细心观察结果,按步骤一步一步排除弱凝集的可能性,对一些疑难问题必须及时请示上级主管,并送上级医院进一步检查。

Analysis of the results and managiment of 40 cases of weak agglutination of ABO blood type test

Objective To analyze and deal with the results of 40 cases of weak agglutination of ABO blood type test by using slide agglutination and tube centrifugation.Methods 40 samples with weak agglutination were washed by water at the temperature of 37 ℃ for 10 minutes,and 9% saline for three times.And the positive and negative stereotypes saline tube test was conducted.The test results of direct antiglobulin were sent to the Department of Blood Transfusion for the appraisal by micro-column gel test,while the controversial ones were sent to Guangzhou Blood Center for identification.Results Among the 40 cases of ABO blood type,there were a total of six cases of weak agglutination,which occurred direct positive antiglobulin.After the procsses of water bath and saline wash,the weak aggregation was reduced by 40% and 52% respectively.In 35 cases,the correlation of the results identified by brine positive and negative stereotyping methods and by consistent micro-gel test was 100%,and the other 5 cases inconsistent with the positive and negative stereotyping and micro-gel test was sent to Guangzhou Blood Center for identification.As a result,there were 4 cases of ABO subtype and 1 case of irregular antibody.Conclusion The test should be done once again when the weak agglutination was found in the identification of ABO blood test,and strict operation rules should be followed as well.And the possibility of weak agglutination should be got rid of with good quality reagents and careful observation,and when came acrross some difficult problems,consult with the higher authorities in time,and sent to higher level hospitals for further examination.