不同血液病患者出血风险度的对比分析  

Comparative analysis of risk degree of bleeding in patients with different kinds of hematonosis

作　　者：胡文静[1] 周荣富[2] 张瑞生[3] 张红梅[4] 

机构地区：[1]南京红十字血液中心,江苏南京210003 [2]南京大学医学院附属鼓楼医院 [3]南京市第一医院 [4]南京市江宁医院

出　　处：《中国输血杂志》2017年第7期706-708,共3页Chinese Journal of Blood Transfusion

基　　金：南京市医学科技发展项目(YKK14170);南京市科技发展指导性计划项目(2015ZD009)

摘　　要：目的通过回顾性分析血液病患者出血时PC与相关因素,计算PC处于各暴露等级时的出血风险。方法回顾性分析2013年7月-2017年6月于南京大学医学院附属鼓楼医院、南京市第一医院、南京市江宁医院血液科住院患者,计算不同血液病的出血风险度。结果 5类血液病对低PC的耐受性相比:AA与ITP能耐受较低的PC水平;MDS与AML(M3除外)较易出血;ALL最易出血。讨论当血小板资源紧缺时,应优先考虑给ALL、MDS与AML患者输注,保证危重患者的生命安全;对于AA与ITP患者,可适当降低血小板输注阈值,减少血小板输注无效的发生率。Objective To retrospectively analyze the platelet count and related factors in bleeding patients with hema- tonosis, and to calculate the risk of bleeding when the platelet count is at each exposure level. Methods Retrospective anal- ysis of patients from Department of Hematology Inpatients in Nanjing Drum Tower Hospital, Nanjing First Hospital and Nanjing Jiangning Hospital from July 2013 to June 2017 was collected. And the risk of bleeding for different hematonosis was calculated. Results The tolerance of the 5 categories of hematonosis to low platelet counts is compared ： AA and ITP can tolerate lower levels of platelet count; MDS and AML（ except M3） are more prone to bleeding; ALL is the most susceptible to bleeding. Conclusion When platelet resources are scarce, priority should be given to ALL, MDS and AML patients, in order to ensure the safety of critically ill patients.For patients with AA and ITP, the platelet infusion threshold may be reduced appropriately, in oder to reduce the incidence of platelet transfusion refractoriness.

关 键 词：血液病 出血风险 血小板计数 

分 类 号：R457.1[医药卫生—治疗学]