1786例血小板输注的疗效分析

Analysis on Effectiveness of Platelet Transfusion in 1786 Patients

本研究旨在观察及分析临床血小板输注的疗效。用全自动血细胞分析仪检测1786例患者血小板输注前及输注后20-24 h静脉血中血小板数,计算血小板回收率(PPR),结合输注血小板后出血表现判断输注疗效,并根据病因、输注次数、输注的血小板种类及是否一次性足量输注对血小板输注有效率进行统计学分析。结果表明:1786例患者总血小板输注有效率为52.5%。按不同病因分组的组间血小板输注有效率有统计学差异(P<0.01),其中白血病组和再生障碍性贫血(AA)组血小板输注有效率最低,与其余组比较均有统计学差异(P<0.05),手术组的血小板输注有效率最高。按血小板输注次数分组的组间血小板输注有效率有统计学差异(P<0.01),且随着输注次数的增加,血小板输注有效率逐步降低。按输注的血小板种类分组,浓缩血小板组(一次足量输注)和单采血小板组血小板输注有效率有统计学差异(P<0.01)。浓缩血小板输注按是否一次性足量输注分组:血小板输注有效率组间无统计学差异(P>0.05)。结论:患者病因和输注次数与血小板输注有效率密切相关;血小板输注次数越多,血小板输注无效的可能性越高;单采血小板疗效明显优于浓缩血小板;浓缩血小板血小板是否足量输注与输注有效率无显著性相关。

This study was aimed to observe and analyze the effectiveness of platelet transfusion.The platelet count of 1786 patients before transfusion and on 20-24 hours after transfusion was determined by using Auto-Hematology Analyzer,the percent platelet recovery（PPR） was calculated,the platelet transfusion efficiency（PTE） was evaluated by PPR and hemorrhage presentation after platelet transfusion,and the PTE was statistically analyzed according to disease cause,transfusion frequency,platelet type and once transfusion amount.The results showed that the total PTE of 1786 patients was 52.5%.The comparion of PTE among groups of diesease cause showed that PTE in luekemia and aplastic anemia（AA） was lowest,as compared with that of other diseases（P〈0.05）,while PTE in operation group was highest.The comparison of PTE among groups of transfusion frequency revealed also statistical difference（P〈0.01）,meanwhile PTE decreased with increasing of transfusion frequency.The comparion of PTE among groups of platelet type（platelet phoresis or platelet concentrate） showed statistical difference（P〈0.01）.The comparison of PTE among groups of platelet concentrate of once transfusion amount showed no stastistcal difference（P〈0.05）.It is concluded that the PTE closely relates with disease cause of patients,moreover transfusion frequency also associates with PTE,the more frequency of transfusion,the higher possibility of transfusion refractoriness.The PTE of platelet pheresis is obviously superior to that of platelet concentrate,while PTE of platelet concentrate not significantly relates with once adeguate or not.