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目的通过分析临床输血不良反应的特征和机制,增强未来对不良反应的预防和应对能力。方法 2012年1月-2014年12月日查阅本院所有输血记录、输血不良反应患者病历,分析不良反应发生的性质、特征、概率和机制。结果输血不良反应率为0.43%(33/7 673)。不良反应最常见的是过敏反应,占72.7%(24/33),其次为非溶血性发热反应,占24.2%(8/33),不良反应率呈逐年下降趋势,分别为0.53%(14/2 646)、0.41%(10/2 449)和0.35%(9/2 578)。3年内输注血制品共49 674袋,其中悬浮红细胞、单采血小板和新鲜冰冻血浆的不良反应发生率分别为0.48%(10/2 067)、0.08%(6/7 251)和0.07%(16/21 925),明显高于其他血液成分。发生不良反应的患者以干部保健一病区14.8%(4/27)和重症监护室4.9%(5/102)居多。老年、有输血史、孕产史的患者容易发生不良反应。结论本院输血不良反应总体发生率较低;提倡少白细胞血制品的应用;老年、有输血史、孕产史、重症患者输血要特别预防和监测;应完善不良反应回报制度,安全输血。
Objective To analyze the characteristics and mechanisms of adverse reactions in clinical transfusion so as to enhance the ability of preventing and coping with adverse reactions in the future. Methods From January 2012 to December 2014, all transfusion records and blood transfusion adverse patient records of our hospital were reviewed. The nature, characteristics, probability and mechanism of adverse reactions were analyzed. Results The adverse reaction rate of transfusion was 0.43% (33/7 673). The most common adverse reactions were anaphylactic reaction, accounting for 72.7% (24/33), followed by non-hemolytic fever (24.2%, 8/33). Adverse reactions were decreasing year by year (0.53% 2 646), 0.41% (10/2 449) and 0.35% (9/2 578). A total of 49 674 bags of transfused blood products were obtained in 3 years. The incidence of adverse reactions of suspended erythrocytes, apheresis platelets and fresh frozen plasma were 0.48% (10/2 067), 0.08% (6/7 251) and 0.07% ( 16/21 925), significantly higher than other blood components. Among the patients who experienced adverse reactions, 14.8% (4/27) were in the cadre health care area and 4.9% (5/102) in the intensive care unit. Elderly patients with a history of blood transfusion and pregnancy are prone to adverse reactions. Conclusion The overall incidence of adverse reactions of blood transfusion in our hospital is relatively low. Advocacy of the application of leukocyte-depleted blood products should be specially prevented and monitored in elderly patients with blood transfusion history, pregnancy history and blood transfusion in critically ill patients.