血小板输注效果的临床观察

Observation on Clinical Effects of Platelet Transfusion

目的通过对临床输注血小板前后相应指标的测定,观察其输注效果,分析输注血小板前的临床指征对血小板增值的影响。方法对64例各类患者输注前后24 h用细胞计数仪计数血小板,计算血小板的校正增值计数（CCI）,观察64例患者101例次输注血小板的疗效。结果按输注后24 h CCI计算,血小板输注无效发生率36.63%,血小板相关抗体检出率37.84%。在回归分析中是否反复输注血小板（X1）、是否有出血表现（X2）、血小板相关抗体（X3）成为血小板输注前主要的临床指征。结论临床输注血小板前血小板基数变异较大,存在滥用的情况;输注血小板的治疗效果与输注次数呈正相关,而且随着输注次数的增加,血小板抗体产生的概率增加;X1、X2、X3是影响临床输注疗效的主要因素,要提高治疗效果最好的办法是制定出统一的临床血小板输注指征。

Objective Through the determination of appropriate indicators before and after clinical platelet transfusion, observe its infusion effect, analyze the clinical indication before platelet transfusion to effect platelet increment. Methods 64 patients of 24h before and after infusion use cell counting instrument to calculate the corrected count increment platelet（CCI） ,observe the efficacy of platelet transfusion in 64 patients with 101 cases. Results According to the calculation of 24 h corrected count increment after infu- sion,the platelet transfusion refractoriness incidence of platelet transfusion is 36.63% ,the detection rate of ptatelct-associated antibody is 37.84%. In regression analysis,the X1 ,X2 ,X3 become the main clinical indications to platelet transfusion. Conclusion The platelet radix before clinical platelet transfusion is larger variation,there exist abuse; the therapeutic effect of platelet transfusion is positively correlated to infusion frequency, with the increase of infusion, the probability of platelet antibody will increase; X1, X2, X3 are the main factors to impact the clinical infusion efficacy, the best approach to improve therapeutic effect is to develop an unified clinical platelet transfusion indication.