冰冻单采血小板与新鲜单采血小板临床应用效果评价

发布时间：2018-02-04 16:03

本文关键词： 冰冻单采血小板新鲜单采血小板临床应用疗效 CCI　出处：《中国输血杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的通过冰冻单采血小板与新鲜单采血小板临床疗效与安全性的回顾性病例对照分析,探讨冰冻单采血小板的临床应用价值。方法利用医院临床用血全程闭环智能路径管理与评价信息系统检索2014年8月-2016年12月血小板输注病例资料2 035例,并筛选出456例纳入临床病例对照研究;根据输注血小板种类分为冰冻单采血小板组(A组,n=199)和新鲜单采血小板组(B组,n=257)。通过对比分析两组病例基本资料、有效性指标及安全性指标,评价冰冻单采血小板的临床应用价值。结果 1)A、B两组病例分别占43.6%(199/456)、56.4%(257/456);A、B组间性别、年龄和内科、外科病例构成比差异均不具统计学意义(P0.05);2)199例A组病例共输注冰冻单采血小板2 275U,其中121例内科病例输注量占60.9%(1 385/2 275),78例外科病例输注量占39.1%8(890/2275);疾病分布中血液系统疾病输注量占49.2%(1 120/2 275),妇产科疾病输注量占10.6%(240/2 275),肿瘤放化疗疾病输注量占6.2%(140/2 275);ABO血型分布构成比分别为O型25.9%、A型22.9%、B型20.7%、AB型30.5%;3)A、B两组病例输血前、后Plt计数差异均具统计学意义(P0.05);而两组间输血前和输后24 h Plt计数、差值、24 h CCI差异均不具统计学意义(P0.05);4)A、B两组血小板输注有效率分别为76.9%、76.7%,组间差异不具统计学意义(P0.05);两组间内科及外科病例疗效差异均不具统计学意义(P0.05),但A组外科病例有效率(84.6%)高于B组外科病例(75.3%);B组内科与外科病例间疗效差异不具统计学意义(P0.05),但A组内科与外科病例间疗效差异具统计学意义(P0.05),外科病例血小板输注无效率(15.4%)明显低于内科病例(28.1%);5)A、B两组输血不良反应发生率分别为3.5%、4.7%,输血死亡率均为0,组间差异不具统计学意义(P0.05)。结论冰冻单采血小板在临床治疗中与新鲜单采血小板具有同等的有效性和安全性,可广泛用于临床,特别是在外科止血疗效上具有一定的优势,但对反复输注或血小板输注无效病例应优先使用新鲜单采血小板。
[Abstract]:Objective to analyze the clinical efficacy and safety of frozen platelets and fresh platelets. To explore the clinical application value of cryopreserved platelets. Methods the clinical data of platelet transfusion cases from August 2014 to December 2016 were retrieved by the hospital clinical blood closed-loop intelligent path management and evaluation information system. Material 2. 035 cases. 456 cases were selected for clinical case-control study. According to the type of transfusion platelets were divided into two groups: group A (group A) and group B (group B). The basic data of the two groups were compared and analyzed. Efficacy and safety indexes were used to evaluate the clinical value of cryopreserved platelets. Results (1) there were 43.6 cases in group A and 45.6 cases in group B (199-456). 56.4A 257R / 456C; There was no significant difference in sex, age, internal medicine, and the ratio of surgical cases between group A and B (P 0.05). 2Three patients in group A received 2275U for transfusion of frozen platelets, of which 121cases of internal medicine accounted for 60.9g / 1 385/2 275U). 78 cases in department accounted for 39.1% 890% 2275%; In the distribution of diseases, the volume of transfusion of diseases of blood system was 49.2% and that of gynecology and obstetrics was 10.6 / 220 / 2275). The infusion volume of tumor radiation and chemotherapy diseases was 6.2 / 140 / 2275U; The composition ratio of ABO blood group was O 25.9B = 22.9A and 20.7B respectively. 3There were significant differences in Plt count between the two groups before and after blood transfusion (P 0.05). However, there was no significant difference in the Plt count and the difference of 24 h CCI between the two groups before and after transfusion (P 0.05). (4) the effective rate of platelet transfusion in the two groups was 76. 9% and 76. 7%, respectively. There was no significant difference between the two groups (P 0. 05). There was no significant difference between the two groups in the curative effect of internal medicine and surgery, but the effective rate of surgical cases in group A was 84.6) higher than that in group B. There was no significant difference in curative effect between internal medicine and surgery in group B, but there was significant difference in curative effect between internal medicine and surgery in group A (P 0.05). The inefficiency of platelets transfusion in surgical patients was 15.4%, which was significantly lower than that in internal medicine cases (28.1D). The incidence of adverse reaction of blood transfusion in group A and B was 3. 5% and 4. 7, respectively. The mortality rate of blood transfusion was 0. Conclusion cryopreserved platelets have the same efficacy and safety as fresh platelets in clinical treatment and can be widely used in clinical practice. Especially in the surgical hemostatic curative effect has certain superiority, but for the repeated transfusion or the platelet transfusion invalid case should be given priority to use the fresh single platelet.
【作者单位】：江西省南昌大学第一附属医院输血科;
【基金】：江西省科技厅支撑计划(20151BBG70216) 江西省科技重大项目(20144BBG70001)
【分类号】：R457.1
【正文快照】： 血小板(platelet,Plt)输注可有效预防和治疗患者因血小板减少或功能异常而导致的出血症状,从而降低出血所致的死亡,在临床输血治疗中具有不可替代的作用[1-2]。近年来,由于临床上血小板需求量的不断增加,血小板供求矛盾日显突出,因新鲜单采血小板有效期仅5d而致使血小板供应库

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