本文關(guān)鍵詞： 冰凍單采血小板 新鮮單采血小板 臨床應(yīng)用療效 CCI　出處：《中國(guó)輸血雜志》2017年07期 　論文類型：期刊論文

【摘要】：目的通過(guò)冰凍單采血小板與新鮮單采血小板臨床療效與安全性的回顧性病例對(duì)照分析,探討冰凍單采血小板的臨床應(yīng)用價(jià)值。方法利用醫(yī)院臨床用血全程閉環(huán)智能路徑管理與評(píng)價(jià)信息系統(tǒng)檢索2014年8月-2016年12月血小板輸注病例資料2 035例,并篩選出456例納入臨床病例對(duì)照研究;根據(jù)輸注血小板種類分為冰凍單采血小板組(A組,n=199)和新鮮單采血小板組(B組,n=257)。通過(guò)對(duì)比分析兩組病例基本資料、有效性指標(biāo)及安全性指標(biāo),評(píng)價(jià)冰凍單采血小板的臨床應(yīng)用價(jià)值。結(jié)果 1)A、B兩組病例分別占43.6%(199/456)、56.4%(257/456);A、B組間性別、年齡和內(nèi)科、外科病例構(gòu)成比差異均不具統(tǒng)計(jì)學(xué)意義(P0.05);2)199例A組病例共輸注冰凍單采血小板2 275U,其中121例內(nèi)科病例輸注量占60.9%(1 385/2 275),78例外科病例輸注量占39.1%8(890/2275);疾病分布中血液系統(tǒng)疾病輸注量占49.2%(1 120/2 275),婦產(chǎn)科疾病輸注量占10.6%(240/2 275),腫瘤放化療疾病輸注量占6.2%(140/2 275);ABO血型分布構(gòu)成比分別為O型25.9%、A型22.9%、B型20.7%、AB型30.5%;3)A、B兩組病例輸血前、后Plt計(jì)數(shù)差異均具統(tǒng)計(jì)學(xué)意義(P0.05);而兩組間輸血前和輸后24 h Plt計(jì)數(shù)、差值、24 h CCI差異均不具統(tǒng)計(jì)學(xué)意義(P0.05);4)A、B兩組血小板輸注有效率分別為76.9%、76.7%,組間差異不具統(tǒng)計(jì)學(xué)意義(P0.05);兩組間內(nèi)科及外科病例療效差異均不具統(tǒng)計(jì)學(xué)意義(P0.05),但A組外科病例有效率(84.6%)高于B組外科病例(75.3%);B組內(nèi)科與外科病例間療效差異不具統(tǒng)計(jì)學(xué)意義(P0.05),但A組內(nèi)科與外科病例間療效差異具統(tǒng)計(jì)學(xué)意義(P0.05),外科病例血小板輸注無(wú)效率(15.4%)明顯低于內(nèi)科病例(28.1%);5)A、B兩組輸血不良反應(yīng)發(fā)生率分別為3.5%、4.7%,輸血死亡率均為0,組間差異不具統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論冰凍單采血小板在臨床治療中與新鮮單采血小板具有同等的有效性和安全性,可廣泛用于臨床,特別是在外科止血療效上具有一定的優(yōu)勢(shì),但對(duì)反復(fù)輸注或血小板輸注無(wú)效病例應(yīng)優(yōu)先使用新鮮單采血小板。
[Abstract]:Objective to analyze the clinical efficacy and safety of frozen platelets and fresh platelets. To explore the clinical application value of cryopreserved platelets. Methods the clinical data of platelet transfusion cases from August 2014 to December 2016 were retrieved by the hospital clinical blood closed-loop intelligent path management and evaluation information system. Material 2. 035 cases. 456 cases were selected for clinical case-control study. According to the type of transfusion platelets were divided into two groups: group A (group A) and group B (group B). The basic data of the two groups were compared and analyzed. Efficacy and safety indexes were used to evaluate the clinical value of cryopreserved platelets. Results (1) there were 43.6 cases in group A and 45.6 cases in group B (199-456). 56.4A 257R / 456C; There was no significant difference in sex, age, internal medicine, and the ratio of surgical cases between group A and B (P 0.05). 2Three patients in group A received 2275U for transfusion of frozen platelets, of which 121cases of internal medicine accounted for 60.9g / 1 385/2 275U). 78 cases in department accounted for 39.1% 890% 2275%; In the distribution of diseases, the volume of transfusion of diseases of blood system was 49.2% and that of gynecology and obstetrics was 10.6 / 220 / 2275). The infusion volume of tumor radiation and chemotherapy diseases was 6.2 / 140 / 2275U; The composition ratio of ABO blood group was O 25.9B = 22.9A and 20.7B respectively. 3There were significant differences in Plt count between the two groups before and after blood transfusion (P 0.05). However, there was no significant difference in the Plt count and the difference of 24 h CCI between the two groups before and after transfusion (P 0.05). (4) the effective rate of platelet transfusion in the two groups was 76. 9% and 76. 7%, respectively. There was no significant difference between the two groups (P 0. 05). There was no significant difference between the two groups in the curative effect of internal medicine and surgery, but the effective rate of surgical cases in group A was 84.6) higher than that in group B. There was no significant difference in curative effect between internal medicine and surgery in group B, but there was significant difference in curative effect between internal medicine and surgery in group A (P 0.05). The inefficiency of platelets transfusion in surgical patients was 15.4%, which was significantly lower than that in internal medicine cases (28.1D). The incidence of adverse reaction of blood transfusion in group A and B was 3. 5% and 4. 7, respectively. The mortality rate of blood transfusion was 0. Conclusion cryopreserved platelets have the same efficacy and safety as fresh platelets in clinical treatment and can be widely used in clinical practice. Especially in the surgical hemostatic curative effect has certain superiority, but for the repeated transfusion or the platelet transfusion invalid case should be given priority to use the fresh single platelet.
【作者單位】： 江西省南昌大學(xué)第一附屬醫(yī)院輸血科;
【基金】：江西省科技廳支撐計(jì)劃(20151BBG70216) 江西省科技重大項(xiàng)目(20144BBG70001)
【分類號(hào)】：R457.1
【正文快照】： 血小板(platelet,Plt)輸注可有效預(yù)防和治療患者因血小板減少或功能異常而導(dǎo)致的出血癥狀,從而降低出血所致的死亡,在臨床輸血治療中具有不可替代的作用[1-2]。近年來(lái),由于臨床上血小板需求量的不斷增加,血小板供求矛盾日顯突出,因新鮮單采血小板有效期僅5d而致使血小板供應(yīng)庫(kù)

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