血液病患者血小板输注无效的原因分析与护理对策  

作　　者：蔡莉莉[1] 

机构地区：[1]河南省商丘市第一人民医院输血科,河南商丘476000

出　　处：《成都医学院学报》2012年第B09期25-26,共2页Journal of Chengdu Medical College

摘　　要：目的：探讨血液病患者血小板输注无效的原因及护理对策。方法：对85例严重血小板减少（PLA〈2．5x10。／L）血液病患者输注机采血小板1治疗量或手工分离浓缩血小板10．5u～12u，检测输注前1h，输注后1h和24h的外周血小板记数，以校正血小板计数值（CCI）判断血小板输注疗效，观察患者出血症状或出血倾向是否改善。结果：血小板输注无效率手工分离组高于机采组（p〈0．01）；血小板输注无效率感染组高于非感染组（p〈0．01）；血小板输注无效率发热组高于非发热组（p〈0．01）；④白血病组与再障组血小板输注无效率无统计学意义（p〉O．05）；⑤输注血小板后51例患者出血症状或出血倾向改善，临床有效率60．OO％。结论：血液病患者输注血小板的效果与选择输注的血小板制剂的种类、输血次数、与患者是否伴有发热、感染有关，白血病组与再障组血小板输注无效率无统计学意义，与两类患者均为反复多次输血患者有关；血小板输注效果的评价以CCI为标准的无效率与？临床观察输注后患者的出血症状或出血倾向改善有效率相符。本组病例均无明显脾肿大，对脾肿大与输注血小板效果的影响有待进一步研究。护理要尽量避免输注无效的诱发因素，预防血小板输注无效的发生，严密观察患者出血症状或出血倾向是否改善。Objective： to study the blood platelet transfusion patients the reason and nursing countermeasures. Methods： 85 cases of serious thrombocytope- nia （PLA 〈 2.5 ×109/ L） blood transfusion in patients with machine platelet 1 amount healed or manual separation enrichment platelet 10.5 u - 12 u, detection 1 h before infusion, infusion I h and 24 h after the peripheral blood counts to correction, small board platelet count value （CCI） to judge platelet transfusion curative effect, observe patients haemorrhage symptom or bleeding tendency is improved. Results： platelet transfusion inefficient manual separation group by group than machine （p 〈 0.01）; platelet transfusion inefficient infection than the infection of group （p 〈 0.01）; platelet transfusion inefficient fever group higher than those of fever group （p 〈 0.01） ; （4） the leukemia group and platelet transfusion of aplastic anemia without efficiency was not statistically signifi- cant （p 〉0.05） ; （5） platelet transfusion after 51 cases of patients haemorrhage symptom or bleeding tendency to improve, clinical effectiveness 60.00%. Conclusions： patients with blood platelet transfusion the effect and the choice of the kinds of platelet transfusion preparation, blood transfusion number, and wheth- er patients with fever, infections, leukemia group and platelet transfusion of aplastic anemia without efficiency was not statistically significant, and two types of patients are repeated transfusion patients involved; Platelet transfusion, to evaluate the effect of the inefficiency of standard for CCI with clinical observation in- fusion of patients after haemorrhage symptom or bleeding tendency is to improve efficiency. All cases were not significantly splenomegaly, to splenomegaly and platelet transfusion effect of the pending further study. Care to avoid as far as possible infusion of invalidation of the inducing factors, prevent the happening of the invalid platelet transfusion, close observation of the bleeding in patie

关 键 词：血液病 血小板 输注效果 护理 

分 类 号：R714.254[医药卫生—妇产科学]