临床急性输血反应的回顾性分析

目的回顾性分析安徽省立医院近年来发生的急性输血反应,为临床减少输血反应、有效处理输血反应提供参考。方法对2012年1月～2013年6月期间输注各种血液成分的住院患者的急性输血反应情况进行调查分析。结果研究期间共有37 857人次输注了108 543 U的各种血液成分；结果158例患者发生159次急性输血反应,反应发生率为0.38%（415/108 543）,其中FNHTR和ATR占97.48%,两者分别为46.54%（74/159）和50.94%（81/159）；不同血液成分中输注红细胞悬液、血浆和血小板的急性反应发生率分别为0.43%（225/52 554）、0.33%（166/50 456）和0.57%（24/4237）；既往输血次数为0、1、2、3次和大于3次的构成比分别为21.38%（34/159）、7.55%（12/159）、10.69%（17/159）、12.58%（20/159）和47.80%（76/159）。结论急性输血反应主要是FNHTR和ATR,以输注血小板的反应发生率最高,发生急性输血反应的病例中输血次数超过3次的比例最高；合理输血、减少血液输注、自体输血是目前预防输血反应最好的措施。

A Retrospectively Analysis of Clinical Acute Transfusion Reactions

Objective To retrospectively study the acute transfusion reaction in Anhui Provinical Hospital in recent years.Methods All transfusion data of hospitalized patients from January 2012to June 2013were subjected to analysis.Results There were 37 857times transfusion with 108 543Uvarious blood conponets.159acute transfusion reactions were observed in 159patients with the incidence rate of 0.38%（415/108 543）.The febrile nonhemolytic transfusion reactions（FNHTR）and allergic transfusion reactions（ATR）accounted for 97.48%（155/159）of the total occurrence.Of all blood components,the incidence of acute transfusion reaction in RBCs,FP and PLT were 0.43%（225/52 554）,0.33%（166/50456）,and 0.57%（24/4 237）,respectively.The constituent rates of 0,1,2,3and more than 3times of transfusion were 21.38%（34/159）,7.55%（12/159）,10.69%（17/159）,12.58%（20/159）,and 47.80%（76/159）,respectively.Conclusion Acute transfusion reactions are primarily FNHTR and ATR in Anhui Provincial Hospital.The highest incidence of acute transfusion reaction happened in platelets transfusion,and most of acute transfusion reactions were noted in patients who had received more than 3times of transfusion.