白细胞过滤全血质量控制及临床之探究.docVIP

白细胞过滤全血质量控制及临床之探究 　[摘要]目的 探讨血液过滤白细胞的质量控制及在临床输血应用价值。方法 分别对不同过滤器过滤白细胞的血液作常规外观、热源及无菌试验质控，并随机抽取902名接受输血的病人进行观察。其中以482名输注采用一次性去除白细胞过滤器病人为观察组，420名输注非过滤白细胞血液的病人为对照组，观察两组输血后不良反应情况。结果 经白细胞滤器过滤的血液各项指标均合格。输血反应发生率观察组为0.4%，对照组为3.8%，观察组明显低于对照组（Plt;0.05）。结论 输注过滤白细胞血液能够减少输血反应发生，是目前较为理想的安全输血方法，但必须对白细胞过滤技术进行严格的质量控制。 关键词: 白细胞 输血反应 白细胞过滤 质量控制 [Abstract] Aims: Discussing the quality control on percolating the white cell from blood and the value of its application on blood transfusion in clinic. Method: Operating the routine test in terms of appearance, heat and asepsis for the blood percolating white cell by different percolator respectively. Randomly selected 902 patients whom took blood transfusion, which 482 among them who had been taken percolated white cell transfusion as observing group that the rest of them who had not as comparison group. Discussing the negative transfuse response from the patients in both groups. Results: All the index values of the blood percolating by white cell percolator were normal. The rate of the occurrence of blood transfusion responses in observing group was 0.4%; much lower than that in comparison group (Pgt;0.05) which is 3.8%. Conclusion: transfused the white cell percolated blood could reduce the occurrence on the transfusion response; hence it is an ideal way of safe blood transfusion currently. But the strict quality control on the technique of white cell percolating should be introduced. Keyword: white cell, transfusion response, white cell percolating, quality control 随着现代输血技术的进步，人们对输血的质量要求越来越高，新一代血液制品去白细胞血液制品在临床上的应用也日趋广泛，输血既能挽救患者的生命，也可引起一些不良反应，甚至是危害严重的传染病。输注含白细胞的全血或血液成分，常引起非溶血性发热反应（WBCNHFR）、成人呼吸窘迫综合症（ARDS）、血小板输注耐受和输血后移植物抗宿主病（GVHD）等输血反应，这主要是由于多次输入的供者白细胞与受者发生同种异体免疫应答而产生的针对白细胞的抗体所致[1]。一般认为血液滤除后的白细胞降至5×108个/L时，可避免因白细胞抗体所致的非溶血性输血发热反应，残留白细胞数小于5×107个/L可使发生输血后移植物抗宿主病的危险大为降低，白细胞降至5×106个/L则可预防HLA抗体所致的同种免疫以几及与白细胞携带病毒相关疾病的传播[2]。 1 材料与方法 1．1对象 2005年1月至2006年7月来自深圳市龙岗区人民医院的住院患者且需输血者902例，其中血液病38例，消化系统疾病204例，有较严重失血的外伤182例，肾病32例，产科及妊娠相关疾病106例，肿瘤216例，其他124