護理師正在監測接受輸血的病人。哪項發現暗示發生溶血性輸血反應？
A nurse is monitoring a client receiving a blood transfusion. Which finding indicates a hemolytic transfusion reaction?
- ADelayed capillary refill毛細血管再充盈延遲
- BItching and hives搔癢與蕁麻疹
- CWheezing and dyspnea喘鳴與呼吸困難
- DLow back pain and fever✓ 正解背痛與發燒
輸血反應中，急性溶血性輸血反應（Acute Hemolytic Transfusion Reaction）是最危險的併發症，通常發生在輸血後的前 15 分鐘內。這是因為受血者體內抗體與輸入的紅血球抗原發生抗原抗體反應，導致紅血球大量破裂，釋放出的血紅素會阻塞腎小管。腰痛（因腎臟充血與血管痙攣）與發燒是溶血反應的典型警訊。
Among transfusion reactions, an acute hemolytic transfusion reaction is the most dangerous complication and usually occurs within the first 15 minutes of transfusion. It arises when the recipient's antibodies react with antigens on the transfused red cells, causing widespread destruction of red blood cells and release of hemoglobin that obstructs the renal tubules. Low back pain (from renal congestion and vascular spasm) and fever are classic warning signs of a hemolytic reaction.