对血液病患者血小板输注无效5种处理方法的临床研究  

Clinic study of five treatment for blood disease patients with PTR

作　　者：黄国盛[1] 柯琳建[1] 陈勇生[1] 卢冰贤[1] 黄慧华[1] 

机构地区：[1]汕头大学医学院第一附属医院,广东汕头515041

出　　处：《河北医学》2001年第8期691-693,共3页Hebei Medicine

摘　　要：目的 :血小板输注无效 (PTR)目前临床无特效方法 ,研究临床常用的 5种处理方法 ,以确定较为有效的方案。方法 :将确定为PTR的血液病患者 60例 ,随机分为 5组 :加大剂量组、血浆置换组、洗涤组、过滤器组、免疫球蛋白组 ,观察 5组患者输注血小板后plt改变 ,校正血小板增值 (CI)及血小板回收率 (PPR)和出血症状的改善效果。结果 :加大剂量组与血浆置换组 ,plt稍有升高 ,洗涤组与过滤器组plt无明显变化 ,均为P >0 .0 5,差异无显著意义 ,CI值及PPR均表示临床无效 ;免疫球蛋白组plt明显升高 ,P <0 .0 5,差异有显著意义 ,CI值及PPR表示临床有效 ;加大剂量组、血浆置换组和免疫球蛋白组改善出血症状明显。结论 :加大输注血小板量与患者进行血浆置换后或大剂量免疫球蛋白滴注后输注血小板均有改善PTR的作用 ,以后者作用最为明显 ,而生理盐水洗涤后与白细胞过滤器过滤后输注血小板则无明显疗效。Objective: To decide which one was the best of 5 treatment which were often used in treating PTR. Methods:60 blood diseases patients were defined to PTR ,and were randomly decided into 5 groups:increase dosage group,plasma exchange group,washing group,filter group and immunoglobulin group. After infuse platelet in the five groups patients, we observe the platelet in the five groups patients,we observe the platelet change, adjust CI, PPR and the resrlt in hemorrhage. Results: Platelet had little increase in the increase dosage group and plasma exchange group,but had no significant difference (P>0.05). Platelet had no change in washing group and filter group. CI and PPR in the four groups indicate that they had no therapeutic effect in clinic. Platelet was increased in the immunoglobulin group(P<0.05),and CI and PPR indicated that it had therapeutic effect. The symptom of hemorrhage was improved in the increase dosage group, plasma exchange group and the immunoglobulin group. Conclusion:Increase dosage of platelet, plasma exchange and give immunoglobulin could improve PTR, the latter was the best.

关 键 词：血液病 血小板输注 疗效 临床研究 PTR 血浆置换 

分 类 号：R457[医药卫生—治疗学]