Rh blood typing

Rh blood type identification generally refers to the detection of D antigen in the Rh system, and is classified into Rh positive and Rh negative according to whether the patient's red blood cells carry D antigen. Rh blood type system generally does not have natural antibodies, so the first blood transfusion will not find Rh blood group incompatibility. However, Rh-negative recipients can produce immunological anti-Rh antibodies after receiving Rh-positive blood. If they are transfused with Rh-positive blood, a hemolytic transfusion reaction can occur. Basic Information Specialist classification: growth and development examination classification: blood examination Applicable gender: whether men and women apply fasting: not fasting Warm reminder: pay attention to disinfection before taking blood, pay attention to prevent wound infection after taking blood. Normal value Rh blood type is divided into Rh positive and Rh negative. Clinical significance a) The Rh-negative rate of Chinese Han people is 0.34%, and most of them are Rh-positive, so the transfusion reaction caused by Rh blood group incompatibility is relatively less than ABO blood type. b) The Rh blood group system generally does not have natural antibodies, so the first blood transfusion will not find Rh blood group incompatibility. However, Rh-negative recipients can produce immunological anti-Rh antibodies after receiving Rh-positive blood. If they are transfused with Rh-positive blood, a hemolytic transfusion reaction can occur. c) Rh-negative mothers are born Rh-positive, the fetal red blood cells enter the mother through the placenta, stimulate the mother to produce anti-Rh antibodies, and then enter the fetus through the placenta, because the first fetus produces little anti-Rh antibodies, very few newborns Hemolytic disease. The second pregnancy Rh-positive fetus, the increase in anti-Rh antibodies produced, can cause neonatal hemolytic disease. If Rh-negative pregnant women have had a history of Rh-positive blood, or the first child has a history of Rh-type miscarriage, the first fetus can also develop fetal hemolytic disease. Precautions Pay attention to disinfection before taking blood. Pay attention to prevent wound infection after taking blood. Inspection process Proteolytic enzyme method (including pineapple enzyme, papain, fig enzyme, trypsin, etc.) Take the pineapple enzyme medium method as an example: (1) Take 1 g of pineapple enzyme, add 100 ml of phosphate buffer pH 5.5, mix well by shaking, place in a 37 ° C water bath for 30 min, centrifuge and precipitate the supernatant, ie 1% pineapple enzyme solution. Store in a refrigerator at 4 °C. (2) The red blood cells and control red blood cells of the test subject were washed once with physiological saline (except for red blood cells with hemolysis), and formulated into a 5% red blood cell suspension. (3) Take 15 small test tubes and divide them into 3 rows. Each row of tubes is labeled in the order of C, c, D, E, and e. (4) Add anti-C serum to the first tube of each row, add anti-c serum to the second tube, add anti-D serum to the third tube, add anti-E serum to the fourth tube, and add 1 drop of anti-e serum to the fifth tube. (5) One row of each tube of the first row plus one red blood cell suspension to be tested, the second row plus positive control red blood cells, and the third row plus negative control red blood cells. (6) Add 1% of 1% pineapple enzyme solution to each tube. (7) Mix and place in a 37 ° C water bath for 1 h to observe the results. If there is no agglutination, the cause should be found. Result interpretation: (1) Observing the naked eye of the test tube, firstly, the positive control tube should be agglutinated, the negative control tube should not be agglutinated, and then the test tube of the test subject is positive for agglutination, and the non-aggregate is negative. If there is doubt in the naked eye, then do a microscopic examination. (2) Record separately, positive or negative. (3) Those who are negative for RhDD should be tested for indirect anti-human globulin to avoid missing Du. Note: Anyone who has Rh antibodies in the body should be given a Rh blood card. When necessary, on the one hand, mobilize the donation of blood, and on the other hand, be vigilant, so as not to accept accidental blood. Saline medium method (1) Test tube method 1 Take 3 small test tubes, 1 for anti-D, 1 for positive control, and 1 with negative control; 2 add 1 drop of anti-D serum reactive at room temperature to the above In the test tube; 3 drops of 5% test tube red blood cell (saline, serum) suspension were added to the anti-D tube, and the corresponding positive red blood cells and negative red cell suspension were added to the positive control and negative control tubes respectively; Evenly, centrifuge at 3000r/min for 15s; 5 take out gently and observe if there is agglutination. Results: Agglutination occurred in the anti-D tube, while the negative control tube did not agglutinate, the positive control tube agglutinated, the test was positive; the anti-D tube and the negative control tube did not agglutinate, the positive control tube agglutinated, and the test subject was negative. (2) Tablet method 1 Take a clean plate, use a marker to draw a small cell, indicate anti-D on the left, a negative control in the middle, and a positive control on the right; One drop of serum was added to the above-mentioned small cells; 3 drops of 5% red blood cell suspension were added to the anti-D cells, and 1 drop of the positive control red cell suspension was added to the positive control cells, and the negative control cells were added to the negative control red cells. 1 drop of the suspension; 4 stir the red cell suspension and the reagent serum thoroughly with a clean glass rod; 5 continuously tilt the plate gently, observe the results within 2 minutes, or observe the results according to the time specified in the reagent manual. Results interpretation: the same test tube method. Not suitable for the crowd Those without examination indications should not be tested. Adverse reactions and risks 1. Infection: Pay attention to aseptic operation when collecting blood, avoid contamination of water and other parts at the blood collection site to avoid local infection. 2, bleeding: after the blood is given a full compression time, especially coagulopathy, bleeding tendency, to avoid local subcutaneous oozing, bruising and swelling.