李绮萍

[摘要] 目的 通过对环境温度的控制减少冷凝集患者输血不良反应的发生。 方法 对照组为常规输血治疗的冷凝集素增高患者15例，经处理37℃交叉相合后，进行常规的输血治疗；观察组的15例是冷凝集素增高患者，经处理37℃交叉相合后，在输血治疗前，对患者输血治疗的环境温度进行加温调整、对患者自身进行保温控制，医护加强输血宣教。 结果 对照组输血治疗15例，其中10例发生输血不良反应；观察组患者输血治疗15例，无输血不良反应的发生。 结论 冷凝集素增高患者输血前排除冷凝集的影响交叉配血相合后，输血治疗过程中的适当的环境温度控制、保温措施和沟通宣教可以减少此类患者的输血不良反应，改善患者的输血感受，顺利完成输血治疗。

[关键词] 高效价冷凝集素；温度控制；交叉配血；输血不良反应

[中图分类号] R446.6；R457 [文献标识码] A [文章编号] 2095-0616（2017）11-155-04

Effect of environmental temperature controlling on blood transfusion of patients with cold agglutination

LI Qiping

Department of Blood Transfusion，Guangdong Provincial Hospital of Integrated Chinese and Western Medicine，Foshan 528200，China

[Abstract] Objective To reduce adverse reactions of blood transfusion of patients with cold agglutination by controlling environmental temperature. Methods 15 patients in the control group were given routine blood transfusion and their cold agglutinin was improved.After blood cross matching with 37 degree，they were given routine blood transfusion.15 patients with increasing cold agglutinin in the observation group were given heat preservation and environmental temperature of their blood transfusion treatment was heated and adjusted before blood transfusion treatment and after blood cross matching with 37 degree.Medical staff was given strengthening publicity and education. Results Of 15 cases with blood transfusion treatment in the control group，there were 10 cases with adverse reactions of blood transfusion.Of 15 cases with blood transfusion treatment in the observation group，there was no case with adverse reactions of blood transfusion. Conclusion For patients with increasing cold agglutinin，eliminating the effect of cold agglutination of patients with increasing cold agglutinin after blood cross matching and controlling environmental temperature，heat preservation measures and communication and publicity and education in the process of blood transfusion treatment can reduce adverse reactions of blood transfusion of such patients，improve feeling of blood transfusion of them and finish blood transfusion treatment smoothly.

[Key words] High-titer cold agglutinin；Temperature controlling；Blood cross matching；Adverse reactions of blood transfusion

在温度较低的情况下红细胞会出现凝集现象并出现阻塞引发雷诺氏征与发绀症状等。该类疾病目前临床上尚无特效治疗方案，以防寒保暖作为主要的治疗措施[1]。冷凝集素增高患者的输血相容性检测需排除冷凝集素的干扰，才能真实检测到患者的血型、不规则抗体和冷凝集素增高患者与供血员的交叉配血情况。我院2013年1月～2014年12月有冷凝集素增高患者輸血治疗15例，其中10例发生输血不良反应。输血不良反应中，7例（70%）表现为输血侧手臂的疼痛，3例（30%）表现为输血侧手臂的疼痛并心悸。2015年输血科改进输血管理流程，在输血相容性检测中，发现有冷凝集现象的患者，输血科提前与科室护士沟通，指导护士做好输血前的准备和输血中的温度控制工作。……