儿童与成人输血不良反应发生率比较

Comparative analysis of the incidence of adverse reactions of blood transfusion among children and adult

摘要:

【摘要】 目的 比较儿童与成人输血不良反应发生率的差异，了解儿童输血不良反应的特征，为儿童输血不良反应诊疗和预防控制提供依据。方法 采用回顾性分析法收集昆明地区两家三级甲等医院输血病例资料59 168人次，发生输血不良反应249人次，比较儿童和成人输血不良反应发生率的差异。结果 研究人群中0～14岁（儿童组）30 518人次，发生输血反应166人次，输血反应发生率054%；18～85岁（成人组）28 650人次，发生输血反应83人次，发生率029%。儿童输血反应发生率是成人的186倍（054%/029%），明显高于成人（P＜005）；儿童输注血小板时输血反应发生率明显高于成人（P＜005），而红细胞和血浆发生率与成人相当；儿童发生的不良反应中，过敏反应占79%，过敏反应的发生率是成人的226倍（043%/019%）。结论 儿童输血不良反应发生率高于成人，尤其在输注血小板时，应严格控制血小板输注指征；儿童过敏反应的发生率较高。皮肤体征或可作为儿科输血时的监测指标和不良反应的早期有效识别，以保障儿童输血安全。

Abstract:

【Abstract】 Objective To compare the difference of incidence of adverse blood transfusion between children and adults, understand the characteristics of children's blood transfusion adverse reactions, and provide basis for diagnosis and control adverse reactions of children's blood transfusion. Methods A retrospective analysis was conducted with collected 59168 cases of blood transfusion cases in two tertiary hospitals in Kunming, and 249 cases of adverse blood transfusion occurred. The difference of incidence of adverse reactions between children and adults was compared. Results The occurrence of blood transfusion response of 30,518 people of 0 ~ 14 years old children was 166 times. The incidence was 054%. The incidence of transfusion reaction in adults (28,650 people) was 029%. The incidence of transfusion reaction was higher than that of children (P＜005). The incidence of blood transfusion was significantly higher in children with platelet blood than in adults (P＜005). The children allergic reactions accounted for 79% in adverse reactions. The incidence of allergic reactions was 226 times of that of adults (043% / 019%). Conclusion The incidence of adverse blood transfusion in children is higher than that in adults, especially in the use of platelet blood components. The incidence of allergic reactions in children is high. It is recommended that the skin signs as a pediatric blood transfusion monitoring indicators in order to effectively identify the early adverse reactions to ensure the safety of children's blood transfusion.