以中部某區域醫院為例──輸血反應頻率及症狀探討

Frequency and Symptoms of Blood Transfusion Reactions in a Regional Hospital in Central Taiwan

由於血品的輸注直接進入人體因此如同藥物一般，可能引起一些副作用及輸血反應。為了了解在本院接受輸血治療的病人發生輸血反應情形，因而探討其發生頻率及症狀種類以期達到預防目標。依本院血庫作業資訊系統及輸血反應回覆單進行統計，統計澄清醫院中港院區2007年5月1日至2007年10月31日間，於本院接受輸血治療患者發生輸血反應人次、症狀及血品，結果顯示本院發生輸血反應頻率以人次計算約為1.57%，若以發血數量(u)來計算約0.96%。受血者發生的輸血反應症狀以發冷發燒居多，共67人，佔總發生人次75.28%，經血庫醫師診斷，絕大多數為非溶血性發燒輸血反應(febrile nonhemolytic transfusion reaction ; FNHTR)，一般認為受血者發生FNHTR一是白血球的抗體和抗原作用引起。本院經輸血委員會對大多數受血者發生非溶血性發燒輸血反應加以探討，並決議對醫護人員推行輸血教育，並依照健保局規定，對因白血球引起之發燒發冷輸血反應二次以上之病患，推行紅血球或血小板減除白血球專用過濾器，以期降低本院FNHTR之發生頻率，邁向病人用血安全輸血零風險的目標。

Because the direct injection of blood into humans is similar to the administration of medications, side effects and blood transfusion reactions may occur. To understand the blood transfusion reactions of patients who receive blood treatment in our hospital and in an effort to prevent such occurrences, we investigated the frequency and types of symptoms associated with blood transfusion reactions. According to the statistics of blood bank operating information systems and the blood transfusion reaction checklist, we collected information regarding the number of people, symptoms, and blood samples from the patients who received blood treatment in the Chun-Kang Branch of our hospital from 1 May 2007 to 31 October 2007. The test results show that the frequency of transfusion reactions calculated by the number of people was approximately 1.57%, and 0.96% if calculated by the quantity of blood delivered (u). A total of 67 transfusion recipients had fevers and chills, and accounted for 75.28% of the patients who had transfusion reactions. According to the blood bank physicians’ diagnoses, most cases were febrile, non-hemolytic transfusion reactions (FNHTR), which are believed to arise from antibodies directed against white blood cell-associated antigens. After the Transfusion Committee of our hospital investigates FNHTR, we have determined to provide medical staff transfusion education and encourage the use of special filters for reducing red blood cell or platelet contamination in order to lower the frequency of FNHTR in our hospital and achieve the goals of blood use safety and zero risk of transfusion for patients.