单采血小板输注无效原因分析及临床对策.docVIP

单采血小板输注无效原因分析及临床对策 吉林大学第四医院输血科吉林省长春市130011 摘要：目的分析临床单采血小板输注无效的原因，为临床科学、 合理、有效使用血小板提供参考依据和对策。方法对46例115例次输注单采血 小板患者按不同疾病和输注频率分组进行统计分析，计算血小板校正增加指数 (CCI)来判断临床疗效。结果血液肿瘤病患者输注血小板无效率明显高于外科 手术及其他疾病患者，差异有统计学意义(Plt;0.05)o低频组血小板输注有效 率高于高频组，差异有统计学意义(Plt;0.05)o结论影响血小板输注疗效的 因素很多。随着输注频率的增加，血小板输注有效率逐渐下降，易产生血小板抗 体，出现血小板输注无效(PTR),临床应进行配合型血小板输注。 关键词：单采血小板；血小板输注无效：血小板校正增加指数 Abstract： Objective To provide evidence and measures for the scientific， reasonable and effective clinical use of platelet through observing and analyzing the clinical curative effect of platelets transfusion.Methods Statistical analysis were carried out for 46 platelet transfused patients (115 times) according to different diseases and transfusion frequency，the peripheral platelets were counted before transfusion and 24 h after transfusion，the clinical effects were evaluated according to the corrected count increment (CCI) .Results The platelet transfusion efficiency in patients with hematologic diseases and tumors was lower than those suffered from surgical operations and other diseases.There was statistical significance in the difference (P lt; 0.05) .Platelet transfusion efficiency of low frequency groups was higher than high frequency groups，the differences had statistical significances (P lt;0.05 ) .Conclusions There were many reasons on the curative effect of platelet transfusion.The curative effect of platelet transfusion is different in different diseases.With the increase of transfusion frequency，platelet transfusion efficiency decreases gradually and even appears platelet antibodies and platelet transfusion refractoriness (PTR) .Platelets transfusion should be coordinated. Key words： platelet； platelet transfusion refractoriness (PTR)； corrected count increment (CCI) 临床治疗性血小板输注显著增多，但多次反复输注血小板的患者, 其临床疗效却不同，甚至出现血小板输注无效（PTR），即患者连续两次输注足量 随机供者血小板后，没有达到合适的校正血小板增高指数值（CCI）,临床表现亦 未有改善［1］。预防和治疗PTR己成为临床输血的棘手问题。为科学、合理、有 效使用血小板，预防和治疗PTR提供参考依据和对策，现就我院血小板输注疗效 情况及原因分析报告如下： 1资料与方法 1.1 2014年1月至11月本院输注单采血小板的住院患者46例， 其中男25例，