Trima Accel机采血小板质量的关键控制点

The critical control point of apheresis platelets by Trima Accel

目的 提高Trima Accel机采血小板的质量.方法 对2011年6月～2012年5月广州血液中心1925名使用Trima Accel机采血小板的献血者进行研究,其中对照组1004人,按常规方法随机分配机器,降低采血速度反应条以减少压力过低报警;轻至中度枸橼酸钠中毒者补充钙剂或降低抗凝剂回输速度,重度枸橼酸钠中毒者停止采集,血液报废.实验组921人,在采集过程中实施5个关键控制点：①献血者的筛选；②采血压力监测；③枸橼酸钠中毒防治；④血小板聚集的处理；⑤心理护理.结果 对照组血小板含量为（2.62±0.04）1011/袋,白细胞混入量为（0.71±0.05）×104/袋,红细胞混入量为（2.86±0.25）×109/袋,中途停机65例,聚集41袋,报废率为6.5％；实验组血小板含量为（2.76±0.02）1011/袋,白细胞混入量为（0.62±0.03）104/袋,红细胞混入量为（2.58±0.13）×109/袋,中途停机16例,聚集17袋,报废率为1.7％;两组血小板含量、白细胞混入量和红细胞混入量比较,差异无统计学意义（P＞0.05）,两组中途停机、聚集和报废率比较,差异有统计学意义（P＜0.05）.结论 把握Trima Accel机采血小板质量的关键控制点,可显著提高机采血小板的质量,降低机采血小板的报废率.

Objective To improve the quality of apheresis platelets by Trima Accel.Methods 1925 donors of apheresis platelets by Trima Accel in Guangzhou Blood Center from June 2011 to May 2012 were studied, 1004 donors of control group,were assigned randomly,the blood flow rate response bar was dropped to reduce the pressure-too-low appear alarm;calcium was supplied or the citrate infusion rate was slow down in light to moderate sodium citrate poisoning,and the product in severe citrate poisoning was stopped collecting and scrap.921 donors were in test group,five critical control points were used in collecting process：①donor screening;②monitoring the blood collecting pressure;③control the citrate poisoning;④deal with the platelet aggregation;⑤psychological care.Results In control group,the products were （2.62±0.04）×10^11/bag of platelets,（0.71±0.05）×10^4/bag of WBCs,（2.86±0.25）×10^9/bag of RBCs,65 cases were stopped collecting,41 products of platelet were aggregated,scrapping rate was 6.5%.In test group,the products were （2.76±0.02）×10^11/bag of platelets,（0.62±0.03）×10^4/bag of WBCs,（2.58±0.13）×10^9/bag of RBCs,16 cases were stopped collecting,17 products of platelet were aggregated,scrapping rate was 1.7%.There was no significant difference in platelet,WBC and RBC count between two groups （P〉0.05）,but the difference in stopping collecting cases,platelet aggregation products and scrapping rate were significant （P〈0.05）.Conclusion The quality of apheresis platelets by Trima Accel can be improved by critical control point to master.