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血站型滤器法制备去除白细胞血液质量控制探讨

2018-09-03王惟李玲玲柴婷婷

中外医疗 2018年9期

王惟 李玲玲 柴婷婷

[摘要] 目的 通过控制滤除白细胞操作过程的关键控制点,了解其对滤白血液质量的影响。方法 随机抽取2016年9—12月份献血屋采集的400 mL全血80袋,按照在滤除白细胞过程中是否对其关键点进行有效控制分为实验组和对照组,比较两组过滤后的血液损失量和过滤效果。结果 实验组和对照组过滤后的血液损失量分别为(43.47±1.45)、(44.83±3.45)g,差异有统计学意义(t=-2.296,P<0.05);两组制备后的去白细胞悬浮红细胞的容量分别为(295.68±18.61)、(293.30±17.13)(t=0.644);血红蛋白含量分别为(55.20±7.18)、(54.55±5.24)(t=0.589);白细胞残留量分别为(1.65±0.87)、(1.64±0.77)(t=0.027);储存期末溶血率分别为(0.082±0.045)%,(0.087±0.050)%(t=-0.451),差异无统计学意义(P>0.05),结果均符合《全血及成分血质量要求》(GB18469-2012)。结论 注重滤白关键操作点,可以降低血液损失量,但对过滤血液的质量无影响。

[关键词] 去除白细胞;操作规范;红细胞损失量

[中图分类号] R457 [文献标识码] A [文章编号] 1674-0742(2018)03(c)-0049-03

Study on Blood Quality Control of Blood Station Type Filter Preparation in Removing the Leukocyte

WANG Wei, LI Ling-ling, CHAI Ting-ting

Changchun Blood Center, Changchun, Jilin Province, 130000 China

[Abstract] Objective To study the effect on post-filtration blood quality by controlling the key control points in the operation process of leukocyte removal. Methods 80 bags of 400 mL whole blood from blood donation room from September to December 2016 were randomly selected and divided into experimental group and control group, according to whether the key points were effectively controlled in the filtering process. The blood loss and filtration effect were compared between the two groups. Results The loss of blood in experimental group and control group after filtration was (43.47±1.45) and (44.83±3.45)g respectively, and there was a significant difference in the two groups(t=-2.296, P<0.05). The hemoglobin contents of leukoreduced suspening erythrocytes after preparation were (295.68±18.61), (293.30±17.13)(t=0.644); the contents of hemoglobin were respectively(55.20±7.18), (54.55±5.24)(t=0.589), the residual leucocyte contents were (1.65±0.87) and (1.64±0.77)(t=0.027); the hemolytic ratios at the end of storage were (0.082±0.045)%,(0.087±0.050)%(t=-0.451). and there was no significant difference between the two groups(P>0.05),And the results met the requirements of Quality requirements for Whole Blood and Blood Components (GB18469-2012). Conclusion Paying attention to the leukocyte-filtered key operation points can reduce the loss of blood, but there is no effect on the quality of filtered blood.

[Key words] Leukocyte removal; Operation specification; Red cell loss

白細胞是细菌和病毒的传播媒介物,血液中一定量的白细胞可能造成非溶血性输血反应,如发热、同种异体免疫反应以及病毒传播[1]。在血液制备时去除白细胞能有效阻止绝大多数白细胞在输血时进入受血者体内,可显著降低TNHTR和HLA同种免疫的发生率,显著减少输血CMV及相关病毒的传播,从而显著降低输血风险[2]。使用白细过滤器去除血液中的白细胞,去除率高,有效成分回收率高,操作简便,无不良反应,是目前最好的去除白细胞的方法[3]。作为血站成分科工作者,应本着提高去白细胞悬浮红细胞质量减少红细胞损失量为原则,两组操作进行白细胞过滤制备去白细胞悬浮红细胞,通过对两组滤白操作红细胞损失量的对比分析,研究有效的预防措施,掌握制备过程中的关键控制点,经过5年多应用,无溶血现象发生,质控结果全部达到国家标准,现报道如下。……

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