单采血小板和浓缩血小板在不同输注策略下的疗效分析

Efficacy of apheresis and concentrated platelets under different transfusion strategies

目的回顾性分析单采血小板和浓缩血小板在不同输注策略下的临床效果,探索更加科学的输血方式。方法收集2020年~2021年期间本院收治的血小板减少症患者279例,按输注策略将其分为A组(单独输注单采血小板),B组(单独输注浓缩血小板),C组(单采血小板和浓缩血小板同时输注)3组,测量3组患者输注前后24 h内的血小板并计算其CCI值,比较3组患者间CCI值,输注有效率及输血不良反应的差别,以及不同血型下3组间的疗效差别。结果单采血小板单独输注的患者输注有效率更高,输血不良反应率更低,但输注疗效较低,仅为(14.63±13.48)(P<0.05);对比浓缩血小板单独输注的患者输注疗效可达(16.00±21.77),但输血有效率较低,输血不良反应率大幅升高;二者同时输注的患者则可以在保持输注疗效(16.21±16.33)的情况下大幅提高输注有效率,降低输血不良反应率。同时不同血型对血小板的输注疗效也存在影响。结论单采血小板和浓缩血小板同时输注的患者可以在保证输注量的情况下有效提高患者的输注疗效,降低输血不良反应率,是具备一定可行性及安全性的输血策略。

Objective To retrospectively analyze the clinical effects of apheresis and concentrated platelets under different transfusion strategies,so as to explore more scientific transfusion strategies.Methods A total of 279 patients with thrombocytopenia,admitted to our hospital during January 2020 and October 2021,were collected.They was divided into group A(apheresis platelet transfusion alone),group B(concentrated platelet transfusion alone),and group C(both apheresis and concentrated platelet transfusion).Platelet count of three groups were measured 24 hours before and after transfusion and their CCI values were calculated and compared to understand the differences in transfusion efficiency and adverse reactions,as well as the efficacy among three groups with different blood groups.Results Patients,received solo apheresis platelets,demonstrated a lower incidence of transfusion refractoriness and adverse reactions,but also a lower treatment efficacy(14.63±13.48)(P<0.05).However,the treatment efficacy of patients,received solo concentrated apheresis,could reach 16.00±21.77,but presented a higher incidence of transfusion refractoriness and adverse reactions.Patients,received both apheresis and concentrated platelets,maintained a good treatment efficacy(16.21±16.33),with a low incidence of transfusion refractoriness and adverse reactions.At the same time,different blood types also affect the treatment efficacy of platelet transfusion.Conclusion The simultaneous transfusion of apheresis and concentrated platelets contributes to the effective treatment of patients and lower incidence of adverse reactions.