| Objective:To detect the distribution of Rh blood group D、C、E antigens in the crowd and to provide patients with blood components with their same blood group antigens as much as possible, guaranteeing the safety of clinical blood transfusion. To analyse all blood transfusion patients specimens with crossmatching incompatibility,antiglobulin positive,irregular antibody-positive in the past one year in our hospital. To compare the clinical outcomes of RhC, RhE same phenotypic blood transfusions and different phenotyp and to discuss the necessarity of routine examination of RhC, RhE antigen before clinical blood transfusion.Methods:1.Using Microcolumn gel technique to detect Rh blood groups of17200cases of inpatients in our hospital,including RhD、RhC、RhE; the results are stored in the transfusion apricot computer software management system.2.Using anti-human globulin method, to test irregular antibodies of all specimens with possible blood transfusion in our hospital.MPT and anti-human globulin method were used to cross matching test.3.To select120patients with upper gastrointestinal bleeding and hemorrhagic shock in our hospital from April2013to October2013,and to clear their ABO blood type and the RhD, and RhC, and RhE blood type.Monitoring closely their life signs,to transfuse2U RBC and to observ the change of Hb and HCT before and after blood transfusion and adverse transfusion reaction between RhC, RhE same phenotypic group(test group) and different group(control group).Results:1.Through Rh blood type identification of the17,200case patients, Rh (D) antigen, Rh (C) antigen and Rh (E) antigen-positive rate were respectively99.72%, 86.88%and48.56%, it was obvious that Rh (E) antigen-negative rate was over50%.2. Since April2013, our department checked out7cases specimens with irregular antibodies-positive and antiglobulin positive and antibodies were primarily anti--E and anti--c of the Rh blood group system.3. The test group and control group,the levels of Hb and HCT there were no significant(P＞0.05); The levels of Hb and HCT after blood transfusion in the test group were significantly higher than in the control group and before blood transfusion (P<0.05);To the control group,there was no significant difference between before and after blood transfusion(P＞0.05).4. In the test group therewas only two cases of post-transfusion fever;but control group hemoglobinuria and backache were apparent after blood transfusion, and both were significantly higher than in the same phenot-ype group (P<0.05).Conclusion:To patients with transfusion history or pregnancy history, if there were anti--E and anti--c of the Rh blood group system in their blood,it is needed to test RhC and RhE blood type before clinical blood transfusion treatment to blood donorers and receptors.When patients needed blood transfusion,RBC of nocorresponding antigen shoulded be not selected,and guarantee there were not hemolysis and agglutination in matching blood test,to reach safe and effective transfusion.We recommend that the relevant departments should test routinely D、C and E antigens of the Rh blood type system of patients and provide patients with blood components with same main antigens when they need blood transfusion, thereby reducing the immune response caused by blood transfusion, implementing scientific RhC and RhE antigen matching blood transfusion, improving the effectiveness of blood transfusion therapy. Meanwhile,we should survey the distribution of RBC blood type antigens in different areas and different ethnic groups,and depending on the characteristics of population distribution devise a routine examination project adapted to national circumstances before blood transfusion, in order to improve blood transfusion safety and efficacy. |
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