郑志民　刘月富

[關键词] 输血反应;过敏反应;非溶血性发热反应;危险因素

[中图分类号] R457.1          [文献标识码] B          [文章编号] 1673-9701（2021）23-0092-04

Research on the adverse reactions of clinical blood transfusion and Logistic regression analysis of its risk factors

ZHENG Zhimin   LIU Yuefu

Department of Blood Transfusion， People′s Hospital in Sanshui District of Foshan City in Guangdong Province， Foshan   528100， China

[Abstract] Objective To analyze the structure and features of adverse reactions（ARs）of clinical blood transfusion， and to investigate the risk factors leading to clinical blood transfusion reactions. Methods In this research， patients who received blood transfusion in People′s Hospital in Sanshui District of Foshan City from January 2016 to December 2019 were selected as the study group （n=87）， and the structure and features of clinical blood transfusion reactions were analyzed. Other patients who received blood transfusion in the same period but did not have blood transfusion reactions were randomly selected as the control group（n=90）. The corresponding factors of the two groups were statistically analyzed. Results The ARs structure of blood transfusion in 87 cases was the allergic reactions（accounting for 50.57%）， the non-hemolytic fever （accounting for 48.27%） and purpura after blood transfusion（accounting for 1.15%）. The top four transfusion components were combined transfusion of plasma/red blood cells， plasma， platelet and leukocytes-free suspended red blood cells.the blood transfusion history， allergy history and immunoglobulin E（IgE） content in the study group were all higher than those in the control group， with statistically significant differences（P<0.05）. However， there were no statistically significant differences in the aspects of age structure， body mass index， education level and occupation structure between the two groups （P>0.05）. Logistic regression analysis showed that the blood transfusion history， allergy history，  irregular antibodies in the patient's blood and  overexpressed immunoglobulin E（IgE） content were independent risk factors for the occurrence of ARs of clinical blood transfusion（P<0.05）. Conclusion The main ARs of blood transfusion are allergic reactions and non-hemolytic fever reactions， and the main components of clinical blood transfusion reactions are the combined transfusion of plasma/red blood cells， simple plasma transfusion and platelet transfusion. The improvement of close monitoring of the blood transfusion process of patients with high expression of IgE， repeated blood transfusion and history of immune diseases may reduce the incidence of ARs of blood transfusion. ARs of blood transfusion are not related to patient themselves′ age， weight， education level and occupational structure.

[Key words] Blood transfusion reactions; Allergic reactions; Non-hemolytic fever reactions; Risk factors

对于失血患者或贫血患者进行输血治疗是一项行之有效的治疗手段，但存在诸多不确定危害因素，临床输血不良反应就是一种常见的危害因素之一。输血不良反应是指患者输血过程中或输血结束后所发生的一系列如过敏、发热、寒战、紫癜等不良反应，给患者治疗带来风险[1-2]。不同地区不良输血反应发生率各不相同，输注不同成分导致的输血不良反应也存在差异[3-4];对于输血不良反应进行有效处置或有针对性的事前防范，能够有效降低输血反应发生率。输注去白细胞悬浮红细胞、辐照红细胞均被认为是降低输血不良反应的有效举措[5];输血前进行不规则抗体的有效筛检，是近年来采取的被认为是降低输血反应的有效措施[6];但这些措施都无法完全避免输血不良反应发生。为降低临床输血不良反应发生率，提高临床安全用血，保障患者权益，本研究对2016年1月至2019年12月到佛山市三水区人民医院输血且发生输血反应患者的87例输血不良反应回报单的病历资料进行回顾性统计分析研究，旨在为降低输血反应、保障安全用血提供循证依據，现报道如下。

1 资料与方法

1.1一般资料

选取2016年1月至2019年12月到佛山市三水区人民医院输血且发生输血反应的87例患者回报资料为研究对象（研究组），其中输血反应定义为在输血及其血液制品过程中或结束后所发生的一系列不良反应，包括但不限于过敏反应、非溶血性发热反应、输血后紫癜、移植物抗宿主病等与输注血液及其制品相关联且与患者自身疾病无关联的一系列症状。……