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目的通过对2例输血相关性肺损伤(transfusion-related actute lung injury,TRALI)的调查并分析其发病因素,为TRALI的预防提供参考。方法回顾性调查2名抢救性患者在输血治疗过程中发生TRALI反应的临床病历和献血者的相关资料,分析发生TRALI的危险因素。结果 2名创伤性手术患者均在输血治疗过程中输入了富含血浆的血液成分而导致TRALI发生,虽经积极抢救,1例治愈,1例死亡。2名TRALI患者所输血液成分来自4名供血者,其中2人为经产妇,另2人均为男性献血者,追踪4名供血者以往的受血者,无1人发生TRALI反应。结论患者输血治疗时有大的创伤性因素存在,是发生TRALI的危险因素;富含血浆是引起发生TRALI的直接诱因,存在TRALI高危因素的患者应尽量减少血浆制品的输入以预防TRALI的发生。
Objective To investigate the incidence of TRALI in two cases of transfusion-related actute lung injury (TRALI) and provide a reference for the prevention of TRALI. Methods Retrospective investigation of clinical data and blood donors’ information of TRALI in two rescue patients during transfusion therapy was performed to analyze the risk factors of TRALI. Results Two traumatic patients underwent transfusion of plasma-rich blood components during transfusion, which led to the occurrence of TRALI. One patient was cured and one died in spite of active rescue. Two of the TRALI patients were transfused from four donors, two of whom were mothers and two of whom were male donors. None of the four transfusion recipients traced previous TRALI reactions. Conclusions There are major traumatic factors in the transfusion of blood transfusion, which are the risk factors of TRALI. Plasma-rich plasma is the direct inducer of TRALI. Patients with high risk of TRALI should minimize the import of plasma to prevent the occurrence of TRALI.