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全自动血型分析仪正反定型不符原因分析与对策探讨

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目的 探讨全自动血型分析仪ABO正反定型不一致原因与解决方法。方法 回顾性分析 2019 年 6 月—2020 年 12 月福建省龙岩市第二医院输血科 25 000 例患者的临床资料。对血型为ABO型的患者使用Autovue Innova全自动血型分析仪进行检测,对出现正反定型不一致的患者进行准确鉴别,并对出现的原因进行分析,从而制订出相应的对策。结果 使用全自动分析仪检出正反型不符的血型标本 80 例,其主要原因有实验室试剂仪器、标本操作的人为因素(36。25%)、ABO亚型(10。00%)、高效价冷凝集菌素(10。00%)、中老年人抗原抗体减(8。75%)等,其中 55 例标本经手工法鉴定纠正。涉及同种异体抗原、低免疫球蛋白、M蛋白等因素导致需要实验室进一步复查纠正。结论 全自动血型分析仪出现正反定型不一致的原因很多,可通过手工试管法进一步对标本进行检测。如果手工鉴定后仍然存在正反型结果不符的情况,应将标本送至化验室内进一步确定,确保患者输血时安全。
Cause Analysis and Countermeasures of Inconsistent Positive and Negative Typing of Full-Automatic Blood Group Analyzer
Objective To explore the causes and solutions of inconsistent ABO positive and negative typing of automatic blood group analyzer.Methods A total of 25 000 voluntary blood donors clinical data in the department of transfusion,the Second Hospital of Longyan,Fujian Province from June 2019 to December 2020 were retrospective analysed.Autovue innova fully automatic blood type analyzer was used to detect voluntary blood donors with ABO blood type.Patients with inconsistent positive and negative blood types were accurately identified,and the causes were analyzed to develop corresponding strategies.Results Using a fully automated analyzer to detect 80 blood type specimens that do not match the positive and negative types,the main reasons were analyzed as laboratory reagents and instruments,human factors in specimen operation(36.25%),ABO subtypes(10.00%),high titer cold agglutinin(10.00%),and reduced antigen antibody levels in middle-aged and elderly people(8.75%).Among them,55 specimens were identified and corrected manually;However,factors such as allogeneic antigens,low immunoglobulin,and M protein still require further laboratory review and correction.Conclusion There are many reasons for the inconsistency of positive and negative typing of automatic blood group analyzer.The samples can be further tested by manual test tube method.If the positive and negative results are still inconsistent after manual identification,the samples should be sent to the laboratory for further determination to ensure the safety of patients during blood transfusion.

fully automatic blood type analyzermismatch between positive and negative typesABO blood typedifficult blood typemanual measurementoperating procedures

林小兰

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福建省龙岩市第二医院输血科,福建 龙岩 364000

全自动血型分析仪 正反型不符 ABO血型 疑难血型 手工测量 操作规程

2024

中国卫生标准管理
《中国卫生标准管理》杂志社

中国卫生标准管理

影响因子:1.374
ISSN:1674-9316
年,卷(期):2024.15(17)