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目的调查输血相关性急性肺损伤(TRALI)在儿童手术输血患者发病情况。方法对2007年1月～2010年12月期间住院的2 495名手术输血儿童调查,分析发生呼吸窘迫或者肺水肿的患者输血情况,结合临床症状和发病时间判断是否为TRALI。同时分析发生TRALI的临床发病特点、实验室检查、影像检查、治疗措施、预后。结果 2 495名儿童3 423次输血,其中35名患者输血后发生出现呼吸系统疾病,2名符合TRALI的临床表现,这2名患者输注的血液制品为女性献血者新鲜冰冻血浆。结论儿童手术输血患者发生TRALI的率为0.58‰,富含血浆的血液制品是引起儿童手术患者发生TRALI的危险因素。
Objective To investigate the incidence of transfusion-associated acute lung injury (TRALI) in children undergoing transfusions. Methods A total of 2 495 hospitalized children undergoing transfusions during January 2007 to December 2010 were enrolled in this study. Blood transfusions were analyzed in patients with respiratory distress or pulmonary edema, and TRALI was determined according to clinical symptoms and onset time. At the same time analyze the occurrence of TRALI clinical features, laboratory tests, imaging, treatment, prognosis. Results A total of 3,243 transfusions were performed in 2 495 children. Of these, 35 developed respiratory disease after transfusion and 2 met TRALI-related clinical manifestations. The transfusions were delivered to freshly frozen plasma from female donors. Conclusion The incidence of TRALI in children with surgical transfusion is 0.58 ‰. Plasma-rich blood products are the risk factors of TRALI in pediatric surgical patients.