摘要
目的回顾性调查辽宁地区输血不良反应实际发生情况,为输血不良反应调查奠定基线数据。方法联合辽宁省内15家三甲医院建立辽宁省输血不良反应分联盟,参照2019版中国血液预警联盟编写临床输血不良反应鉴别诊断标准及处理流程,统一调查方法及诊断依据,2019年9月-10月回顾性调查各院连续100份临床输血病历,共计1500例,结合输血不良反应临床报告单和电子病历调查输血不良反应的发生情况。结果本调查覆盖临床各科室,共计输血1500例,其中男性749人,女性751人,共输注红细胞悬液5 696 U,病毒灭活冰冻血浆318 500 mL,滤白冷沉淀1 869 U,滤白机采血小板368治疗量,不良反应发生31次(不良反应发生率为3.22%,2.07次/100人,0.28次/100 U输血),输血科接到不良反应回报13例(回报率41.94%)。不良反应类型以非溶血性发热反应和过敏反应最多,另外包括输血相关低血压、迟发性溶血性输血反应、输血相关循环超负荷。结论调查显示辽宁地区输血不良反应实际发生率高于临床回报率,加强临床医护人员培训、提高输血不良反应监控意识,完善血液预警系统建立及上报流程,以保证临床用血安全。
Objective To investigate the current state of adverse reactions to clinical transfusion in Liaoning province, in order to provide baseline data for further study.. Methods Liaoning Provincial Blood Hemovigilance Sub-alliance was established in conjunction with 15 tertiary hospitals across Liaoning province. According to the unified investigation procedures and diagnosis protocols on adverse reactions to clinical transfusion(version 2019) edited by China Blood Hemovigilance Alliance, a total of 1500 clinical records(100 consecutive cases per hospital) were retrospectively reviewed.The prevalence of adverse reactions to blood transfusion were analyzed based on the clinical reports regarding adverse reactions and electronic medical records.Results A total of 1500 patients, consisting of 749 males and 751 females, from 15 hospitals received blood transfusion, including an overall volume of RBC suspension in 5 696 U, virus inactivated frozen plasma in 318 500 mL, cryoprecipitates in 1 869 U, leukocyte delepted apheresis platelet in 368 dosage. The adverse reactions occurred in 31 occasions with an incidence at 3.22%(2.07 occasions per 100 patients;0.28 occasions per 100 U). and 13 out of 31(41.94%) adverse reactions were reported to. Department of Blood Trasnsfusion. Non-hemolytic febrile reaction and allergic reaction were the two leading causes of adverse reactions, followed by transfusions-related hypotension, delayed hemolytic transfusion reaction, and transfusions-related cycle overload. Conclusion This investigation revealed that the actual incidence of adverse reactions to blood transfusion in Liaoning is higher than the clinical reporting rate. We should strengthen the training of clinical medical staff, improve the awareness of monitoring adverse reactions, optimize the blood hemovigilance system and facilitate access to reporting adverse cases,, thus to ensure the safety of clinical blood use.
作者
郝欣欣
王秋实
王玉婷
张毅
汪艳
马晓楠
张佳音
李艳菊
关玲
聂冰曦
阎妍
胡婷婷
王涵
孙璐璐
国九英
肖湘
王一冰
刘忠
HAO Xinxin;WANG Qiushi;WANG Yuting;ZHANG Yi;WANG Yan;MA Xiaonan;Zhang Jiayin;LI Yanju;GUAN Ling;NIE Bingxi;YAN Yan;HU Tingting;WANG Han;SUN Lulu;GUO Jiuying;XIAO Xiang;WANG Yibing;LIU Zhong(Liaoning Provincial Blood Hemovigilance Sub-alliance,Institute of Blood Transfusion;Chinese Academy of Medical Sciences and Peking Union Medical College)
出处
《中国输血杂志》
CAS
2020年第8期809-813,共5页
Chinese Journal of Blood Transfusion
基金
中国医学科学院创新工程(2016-I2M-3-024)
辽宁省科学技术基金(2018225088)
关键词
输血不良反应
血液预警
非溶血性发热反应
transfusion adverse reaction
haemovigilance
non-hemolytic febrile reaction
