临床应用低温保存血小板的8年回顾性研究

Retrospective study of the clinical application of cryopreserved platelets transfusion during the past 8 years

目的探讨低温保存血小板应用于临床应的有效性和安全性。方法对本院内外科8年来因血小板减少引起出血以及有严重出血倾向、并输注了低温保存血小板的病例,作回顾性分析:1)低温保存血小板的临床使用比例;2)低温保存血小板在临床各病种的应用情况;3)低温保存血小板的输注疗效;4)低温保存血小板输注的不良反应比例。结果低温保存血小板在本院的用量逐年增加,8年间其平均用量占总用血量的12%(23 857/197793);输注的低温保存血小板的A、B、O及AB红细胞血型的比例分别为27%、31%、33%和9%;抽取8年间临床使用低温保存血小板的病例1 900例,输注了低温保存血小板的主要病种主要有14种疾病(严重复合伤、颅脑外伤、D IC、肝硬化食管静脉曲张破裂出血、产后大出血、髋关节置换术、冠状动脉搭桥子宫内膜癌、卵巢肿瘤、腹膜后肿瘤、急性白血病、再生障碍性贫血、化疗和放疗所致的血小板减少、其他原因所致的血小板减少);追踪356例输注低温保存血小板的病例,其96%(341/356)患者0.5—2 h内出血完全或基本停止,止血效果很明显,72%(256/356)血小板计数(P lt)比输注前明显升高;输注低温保存血小板后发生过敏反应者6例,发热反应者9例。结论输注低温保存血小板具有明显止血和提高外周血P lt的效果。

Objective To estimate the efficacy and safety of the cryopreserved platelets transfusion in clinical practice. Methods A cohort of cryopreserved platelets receipts with hemorrhage or with impending risk of hemorrhage induced by thrombocytopenia or functional platelet defection during the past 8 years was included in our study. Such items as follows were studied retrospectively： 1 ） the percentage of cryopreserved platelets transfusion in the allogeneic blood transfusion ,2 ） major diseases of the cryopreserved platelets transfusion receipts ,3） the effect of the cryopreserved platelets transfusion,4） the rate of the side effects of the cryopreserved platelets transfusion. Results The usage of cryoprcserved platelets increased year by year,accounting for 12% （ 23 857/197 793 ） of the allogenie blood transfusion,with the percentage of type A, B ,O and AB was 27% ,31% ,33% and 9% ,respectively. Patients with aeute thrombocytopenia or perioperative bleeding were the major receipts of cryoprcserved platelets. Obvious haemostatie effects were observed in 96% （ 341/356 ） of receipts, and increased platelet level in 72% （ 256/356 ）. But 6 receipts had allergic reaction and 9 had febrile reaction. Condnsion Cryopreserved platelets transfusion was effective in homeostasis and in the improvement of platelet count. Com- pared with liquid-preserved platelets;cryopreserved platelets have the advantages of large stock, much longer shelf life, and capacity to meet with urgent massive clinical demand.