目的 明确输血前各抗体的分布特点,探讨自身抗体和同种抗体在性别、年龄、输血史、妊娠史和不同疾病中的差异,并根据抗体血型血清学特性制定个体输血方案,以确保临床输血安全。方法 选取2021年6月—2024年8月在广东省第二人民医院输血科申请输注红细胞或手术备血的29 662例患者,采用低离子抗人球蛋白微柱凝胶法进行不规则抗体筛查,结果阳性的标本经科内讨论并送广州血液中心血型参比实验室进行抗体鉴定,通过统计血液中心回报结果分析各抗体的特异性。结果 29 662例患者标本中不规则抗体结果为阳性的有208例,阳性率为0.70%。同种抗体占比47.69%,Rh、MNS和Lewis红细胞血型系统共占同种抗体中的94.50%,其中常见意外抗体:抗-E占31.87%、抗-M占14.29%、抗-Mur占19.78%、抗-C占7.69%和抗-e占7.69%。同种抗体与自身抗体在性别、年龄、妊娠史等方面比较差异无统计学意义(P>0.05);在输血史及不同科室疾病等方面比较差异有统计学意义(P<0.05)。结论 输血前进行输血相容性检测是必要的,应对拟申请红细胞的患者进行不规则抗体筛查,阳性者宜进行抗体鉴定,明确其抗体的特异性及临床意义,以确保临床输血安全。
Objective To clarify the distribution characteristics of each antibody before transfusion,to explore the differences between autoantibodies and homologous antibodies in gender,age,history of blood transfusion,history of pregnancy and different diseases,and to formulate individual transfusion protocols based on the serological characteristics of antibody blood groups to ensure the safety of clinical blood transfusion.Methods A total of 29 662 patients who applied for red blood cell transfusion or surgical blood preparation in the hospital from June 2021 to August 2024 were selected for irregular antibody screening by low-ion anti-human globulin microcolumn gel method.The samples with positive results were discussed within the department and sent to the Blood Type Reference Laboratory of Guangzhou Blood Center for antibody identification.The specificity of each antibody was analyzed by blood center reported results.Results Among 29 662 patients,208 were positive for irregular antibody,the positive rate was 0.70%.The alloantibodies accounted for 47.69%,Rh,MNS and Lewis erythrocyte blood group system accounted for 94.50% of alloantibodies,among which the common unexpected antibodies were anti-E 31.87%,anti-M 14.29%,anti-MUR 19.78%,anti-C 7.69% and anti-E 7.69%.There were no significant differences between alloantibodies and autoantibodies in gender,age and pregnancy history(P>0.05).There were statistically significant differences in blood transfusion history and diseases in different departments(P<0.05).Conclusions It is necessary to test the compatibility of blood transfusion before transfusion.Screening for irregular antibodies should be carried out in prospective transfusion patients,and antibody identification should be carried out in positive patients to clarify the specificity and clinical significance of their antibodies to ensure the safety of clinical transfusion.
目的 评价现有关于干预组仅涉及不同针具针刺或联合常规针刺治疗腰椎间盘突出症系统评价的方法学质量,以比较不同针具针刺治疗腰椎间盘突出症的治疗效果。方法 通过CNKI(中国知网)、万方数据库、VIP(维普)、PubMed、Web of Science等数据库以及其他相关电子资源,对诊断、治疗腰椎间盘突出症的多种针灸技术进行全面的研究。使用AMSTAR2软件,对所有参与的系统性评估结果进行地分析,并根据不同的检测结果,确定文献筛选标准。通过Revman5.4和Cochrance风险偏倚工具,以及Stata16.0的网格Meta分析,挑选了3 381个满足纳入排除要求的随机对照试验。结果 以Stata 16.0统计软件制作排序图可知,杵针+电针的临床有效率SUCRA=81.6%排名第一;目测类比评分显示,银质针SUCRA(用于评估疗效的指标)=95%,排名第一。结论 根据现有的研究证据,杵针+电针以及银质针优于其他9种干预措施,但确切的结果仍需要大量的随机对照试验来证明。
Objective To evaluate the methodological quality of the existing systematic evaluation of the intervention group involving only different needle sets of acupuncture or combined with conventional acupuncture in the treatment of lumbar disc herniation,in order to compare the therapeutic effect of different needle sets of acupuncture in the treatment of lumbar disc herniation.Methods Through CNKI,Wanfang database,VIP,PubMed,web of science and other databases as well as other relevant resources,a variety of acupuncture techniques for the diagnosis and treatment of lumbar disc herniation were comprehensively studied.Through the use of AMSTAR2 software,all participating systematic evaluation results were effectively analyzed,and according to different test results,which literature meets the requirements were determined.Through revman5.4,Cochrane risk bias tool,and grid meta-analysis of stata16.0,3 381 RCTs meeting the inclusion and exclusion requirements were selected.Results According to the ranking chart made by stata16.0 statistical software,the clinical effective rate of pestle needle + electroacupuncture ranked first with sucra=81.6%.According to the visual analogy score,the silver needle sucra=95%,ranking first.Conclusions According to the existing research evidence,pestle needle + electroacupuncture and silver needle are better than the other nine interventions,but the exact results still need a large number of randomized controlled trials to prove.