贫血病人血液标本对两种配血方法的影响

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作者：邓光权　　作者单位：广东省粤北人民医院，韶关 512026

 

【摘要】为了比较贫血病人低红细胞浓度对盐水介质配血及改良聚凝胺配血的影响，将30例贫血病人每人抽取的静脉血4 ml，注入干试管2 ml，另外2 ml注入38%枸橼酸钠管作为交叉配血标本。干试管和枸橼酸钠管标本分别用离心机2500r/分钟离心10分钟，分离出血清尽量取足量的红细胞50 μl进行稀释，病人红细胞以盐水稀释成3%作为原液进行不同的稀释并与O型血的血清作盐水介质配血及改良聚凝胺配血，测试两种方法出现凝集反应。 结果表明： 从观察结果看，盐水配血法在红细胞较高浓度时比聚凝胺的凝集结果难以观察，红细胞相对低浓度时聚凝胺配血比盐水配血结果难以观察。有2例在各个浓度的血球配血时都出现溶血，而干试管取血时，有部分标本没办法得到足量的红细胞。结论： 由于贫血病人的标本红细胞很少，红细胞量不足会使配血结果难于观察，容易造成配血假阴性。如果用干燥试管抽血样，则血块凝结，有时很难分离到红细胞，如果用竹签挤压获取红细胞，则会造成标本溶血，同样也会造成溶血性假阴性反应。所以给贫血病人配血只能用枸椽酸钠管采血。黄疸及溶血病人标本应把红细胞洗涤后再配血。

 

【关键词】 贫血

 

 

Abstrat To compare the influence between physiological saline cross-matching and modified polybrene cross-matching for low concentration erythrocytes in anemia patients，4 ml venous blood was take out separately from each of 30 anaemia patients. 2 ml was injected to dry test tube，the other 2 ml to the tube with 38% of sodium citrate for the sample of cross-matching.All samples had been centrifugated for 10 minutes at 2500r/min.The sera were separated adn 50 ul of erythrocytes were aspirated. The erythrocytes of the patients were diluted to 3% with physiological saline as stock solution.After these solutions being diluted with serum of O blood group using physiological saline and polybrene as medium matching blood，the occurrence of agglutination reaction would be tested.The results showed that reactionsof physiological saline cross-matching is more difficult to be observed than that of the polybrene cross-matching while erythrocytes with high concentration，however，it is opposite at low concentration of erythrocytes.Hemolysis appeared in two patients at cross-matching erythrocytes with different concentrations.Some of samples could not reach to enough erythrocytes with dry tubes.It is concluded that because of less erythrocytes in the sample of anaemia patients，it is more difficult to observe the results in cross-matching，and easy to get false negative reaction.Sometimes it is difficult to get enough erythrocytes by centrifugating as blood sampting with dry tubes.There would be hemolysis and false negative reaction，if you take out erythrocytes by extruding with bamboo.The only right way is using the tubes of sodium citrate for cross-matching of anemia patients.

Key words anaemia modified polybrene cross-matching; physiological saline cross-matching hemolysis

 

 

对贫血病人来说，输血是非常重要的，配血自然也必不可少，如果配血中出现假阴性，则临床输血后会引起不堪设想的后果。假阴性的表现可以有凝集反应不出现或观察不到和溶血反应不能反映，因此要保证配血的质量对标本的要求不容忽视。现将我们对贫血病人的配血结果和应注意环节报告如下。