首页|711名儿童患者输血反应回顾性分析

711名儿童患者输血反应回顾性分析

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目的 分析儿童患者输血反应的特征及相关影响因素,为临床应对和预防输血反应提供依据。方法 以苏州大学附属儿童医院 2019-2023 年接受输血治疗的患儿作为研究对象,回顾性研究期间输血反应发生率、反应类型、发生时间及相关影响因素。结果 2019-2023 年本院共计输血 69 926 人次,发生输血反应 711 例,输血反应发生率为 1。02%。2019 年(1。89%)至 2022 年(0。50%),输血反应发生率在逐年降低。按输注的血液成分来看,输注单采血小板、冰冻血浆、悬浮少白细胞红细胞和冷沉淀凝血因子的输血反应发生率分别为 2。16%(551/25 565)、0。50%(92/18 277)、0。25%(65/25 679)和 0。74%(3/405),且相比于其他血液成分,输注单采血小板有更高的不良反应发生率,差异有统计学意义(P<0。05)。按输血反应类型来看,过敏反应占比 86。22%(613/711),非溶血性发热反应(febrile non-hemolytic transfusion reaction,FNHTR)占比 13。08%(93/711),急性溶血性输血反应占比 0。70%(5/711),且多因素Logistic回归分析显示输注单采血小板是发生过敏反应的独立危险因素(P<0。05),而输注悬浮少白细胞红细胞是发生FNHTR的独立危险因素(P<0。05)。按输血反应发生时间来看,相比于单采血小板和冰冻血浆,输注悬浮少白细胞红细胞引发的输血反应的发生时间更晚(单采血小板P<0。05,冰冻血浆P<0。05)。结论 输注的血液成分是患儿输血反应特征的重要影响因素,可以影响输血反应的发生率、反应类型和发生时间,为临床应对和预防输血反应提供了案例参考与理论指导。
Transfusion reactions in 711 pediatric patients:a retrospective analysis
Objective To analyze the characteristics and related influencing factors of transfusion reactions in pediatric patients,so as to provide evidence for clinical treatment and prevention of transfusion reactions.Methods A retrospective study was conducted on children who received blood transfusions at our hospital from 2019 to 2023 in terms of the incidence,types,time of occurrence,and related influencing factors of transfusion reactions.Results A total of 69 926 transfusions were performed from 2019 to 2023,with 711 cases of transfusion reactions,resulting in an incidence of 1.02%.The inci-dence of transfusion reactions decreased annually from 2019(1.89%)to 2022(0.50%).The incidence of transfusion reac-tions to apheresis platelets,frozen plasma,suspended leukocyte-depleted red blood cells and cryoprecipitate coagulation fac-tor were 2.16%(551/25 565),0.50%(92/18 277),0.25%(65/25 679)and 0.74%(3/405),respectively,with a-pheresis platelet transfusion of a significantly higher incidence compared to other blood components(P<0.05).As of trans-fusion reaction types,allergic reactions accounted for 86.22%(613/711),febrile non-hemolytic transfusion reactions(FNHTR)accounted for 13.08%(93/711),and acute hemolytic transfusion reactions accounted for 0.70%(5/711).Multivariate logistic regression analysis showed that apheresis platelet transfusion was an independent risk factor for allergic reactions(P<0.05),while suspended leukocyte-depleted red blood cells transfusion was an independent risk factor for FNHTR(P<0.05).In terms of the occurrence time of transfusion reactions,compared to apheresis platelets and frozen plas-ma,transfusion reactions caused by suspended leukocyte-depleted red blood cells transfusion occurred later(apheresis platelets P<0.05,frozen plasma P<0.05).Conclusion The results suggest that blood components transfused are significant influencing factors for the characteristics of transfusion reactions in pediatric patients,affecting the incidence,types,and oc-currence time of transfusion reactions,which provides reference for clinical treatment and prevention of transfusion reactions.

childrentransfusion reactionsinfluencing factorsallergic reactionsfebrile non-hemolytic transfusion reactions(FNHTR)

付宏煜、朱志宸、冯立、高雨晴、凌婧

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苏州大学附属儿童医院 输血科,江苏 苏州 215002

苏州大学附属第二医院 检验科

儿童 输血反应 影响因素 过敏反应 非溶血性发热反应

苏州市科技计划苏州市科技计划

SKY2022012SZS2023014

2024

中国输血杂志
中国输血协会 中国医学科学院输血研究所

中国输血杂志

CSTPCD
影响因子:1.279
ISSN:1004-549X
年,卷(期):2024.37(6)