低温保存血小板在外科手术的应用

Transfusion of Cryopreserved Platelets to Surgical Patients

目的 研究低温保存血小板在外科应用的有效性和安全性。方法 输注对象为外科患者术中、术后出血或血小板减少引起出血以及有严重出血倾向患者。观察指标①输注前、后 2h出血时间 ;②输后伤口停止出血时间 ;③输注前、后 1h患者血小板计数 ;④根据①、②和③的结果判断输注低温血小板是否有效 ;⑤术前、术后血小板计数 ;⑥不良反应。结果 出血时间 :输前 (9± 3)min ,输后 (4± 2 )min(P <0 .0 1) ;输后 1h比输前血小板升高 (5～42 )× 10 9/L ;止血有效率为 95 % (2 2 6 / 2 38)。血小板计数 ,术后比术前下降 (130± 6 9)× 10 9/L。过敏反应 4例 ,发热反应 5例。结论 输注低温保存血小板具有明显止血和提高外周血血小板计数的效果。

Objective To estimate the efficacy and safety of cryopreserved platelets in surgical patients.Methods 238 patients in recent years with hemorrhage or high risk of hemorrhage induced by thrombocytopenia or functional platelet defects during or after surgery, who had been transfused with cryopreserved platelets, were included in our study. The following items were recorded: bleeding time before and two hours after transfusion of cryopreserved platelets; the persist time of blood oozing from wound after transfusion; platelet count before and one hour after transfusion; platelet count before and immediately after surgery; and the number of patients with adverse transfusion reactions. The hemostatic efficacy was judged by the bleeding time and platelet count change.Results Bleeding times before and two hours after cryopreserved platelets transfusion were (9±3)min,(4±2)min respectively; blood oozing from wound stopped 0.5～2 hours after transfusion; the platelet level was elevated by(5～42)×10 9/L one hour after transfusion; the postoperative platelet count was decreased by(130±69)×10 9/L compared to preoperative count; four patients had urticaria and five had febrile reaction. The hemostatic efficacy was 95%(226/238) Conclusion Cryopreserved platelets function immediately to bring about the cessation of blood oozing from the wound,and elevation of peripheral blood platelet count.