護理師正在照顧一位接受輸血的病人。病人突然出現呼吸困難、腰部疼痛和血紅素尿。護理師應懷疑哪項併發症？
A nurse is caring for a client receiving a blood transfusion. The client suddenly develops shortness of breath, flank pain, and hemoglobinuria. Which complication should the nurse suspect?
- AAllergic reaction過敏反應
- BCirculatory overload循環負荷過多
- CAcute hemolytic transfusion reaction✓ 正解急性溶血性輸血反應
- DFebrile nonhemolytic transfusion reaction非溶血性發燒性輸血反應
急性溶血性輸血反應（Acute hemolytic transfusion reaction, AHTR）通常發生在輸血後數分鐘至數小時內，其機轉為受體體內抗體與輸入的捐贈者紅血球發生抗原抗體結合，導致紅血球大量破壞（溶血）。血紅素被釋放至血液中經腎臟濾出，導致腰痛（腎臟腫脹）、血紅素尿、呼吸困難及休克。此為輸血反應中最危急的一種，必須立即停止輸血並啟動緊急處理程序。
The sudden onset of shortness of breath, flank pain, and hemoglobinuria during a transfusion indicates an acute hemolytic transfusion reaction, caused by the destruction of donor red blood cells due to antigen-antibody incompatibility. This is a life-threatening emergency that requires immediate cessation of the transfusion, maintenance of IV access with normal saline, and notification of the provider. Symptoms like hives suggest allergic reactions, while fever alone suggests febrile nonhemolytic reactions.