冰冻单采血小板与新鲜单采血小板临床应用效果评价  

Evaluation of the clinical application efficacy of cryopreserved apheresis platelets and fresh apheresis platelets

作　　者：杨丽云[1] 吴承高[1] 刘威[1] 李松[1] 杨鹃[1] 邹娟[1] 乐爱平[1] 

机构地区：[1]江西省南昌大学第一附属医院输血科,江西南昌330006

出　　处：《中国输血杂志》2017年第7期730-733,共4页Chinese Journal of Blood Transfusion

基　　金：江西省科技厅支撑计划(20151BBG70216);江西省科技重大项目(20144BBG70001)

摘　　要：目的通过冰冻单采血小板与新鲜单采血小板临床疗效与安全性的回顾性病例对照分析,探讨冰冻单采血小板的临床应用价值。方法利用医院临床用血全程闭环智能路径管理与评价信息系统检索2014年8月-2016年12月血小板输注病例资料2 035例,并筛选出456例纳入临床病例对照研究;根据输注血小板种类分为冰冻单采血小板组(A组,n=199)和新鲜单采血小板组(B组,n=257)。通过对比分析两组病例基本资料、有效性指标及安全性指标,评价冰冻单采血小板的临床应用价值。结果 1)A、B两组病例分别占43.6%(199/456)、56.4%(257/456);A、B组间性别、年龄和内科、外科病例构成比差异均不具统计学意义(P>0.05);2)199例A组病例共输注冰冻单采血小板2 275U,其中121例内科病例输注量占60.9%(1 385/2 275),78例外科病例输注量占39.1%8(890/2275);疾病分布中血液系统疾病输注量占49.2%(1 120/2 275),妇产科疾病输注量占10.6%(240/2 275),肿瘤放化疗疾病输注量占6.2%(140/2 275);ABO血型分布构成比分别为O型25.9%、A型22.9%、B型20.7%、AB型30.5%;3)A、B两组病例输血前、后Plt计数差异均具统计学意义(P<0.05);而两组间输血前和输后24 h Plt计数、差值、24 h CCI差异均不具统计学意义(P>0.05);4)A、B两组血小板输注有效率分别为76.9%、76.7%,组间差异不具统计学意义(P>0.05);两组间内科及外科病例疗效差异均不具统计学意义(P>0.05),但A组外科病例有效率(84.6%)高于B组外科病例(75.3%);B组内科与外科病例间疗效差异不具统计学意义(P>0.05),但A组内科与外科病例间疗效差异具统计学意义(P<0.05),外科病例血小板输注无效率(15.4%)明显低于内科病例(28.1%);5)A、B两组输血不良反应发生率分别为3.5%、4.7%,输血死亡率均为0,组间差异不具统计学意义(P>0.05)。结论冰冻单采血小板在临床治疗中与新鲜单采血小板具有同等的有效性和安全性,可广泛用于�Objective To evaluate the clinical value of apheresis platelets throught heanalysisof case control on the clinical efficacy and safety of cryopreserved apheresis platelets and fresh apheresis platelets. Methods 2 035 clinical cases of platelet transfusion in August 2014 to December 2016 by Using the closed loop intelligent path management and evaluation information system,456 cases were selected as control cases.Platelets were divided into the cryopreserved apheresis platelets group （group A, n= 199） and fresh apheresis platelets group （group B, n= 257） according to the transfused platelet type . The clinical application value of cryopreserved single platelets was evaluated by comparing the basic data, the effective indexes and safety indexes of the two groups. Results 1 ） The cases were 43.6% （199/456） in A groups, and 56. 4% （ 257/ 456） in B groups , there were no significant difference in gender, age and medical and surgical cases between A and B group （P〉0. 05） ; 2） 199 cases in group A were eryopreserved platelets of 2 275 U, including 121 medicine cases , the total amount of transfusion was about 60. 9% （ 1 385/2 275）, 78 surgical cases accounted for 39. 1% （890/2 275） ; In the distribution of diseases, the blood system diseases accounted for 49.2% （ 1 120/2 275）, the total amount of obstetrics and gynecology disease infusion accounted for 10. 6% （240/2 275） , and the amount of tumor radiotherapy and chemotherapy accounted for 6. 2% （ 140/2 275） ;The proportion of ABO blood type distribution was O type 25.9%, A type 22. 9%, Btype 20.7%, ABtype 30. 5% , respectively; 3） The Pit counts of group A and B were significantly different before and after transfusion （P 〈0. 05）. But there was no significant difference between the two groups of cases before transfusion and 24h Pit count after transfusion, the Pit counts difference, and 24 h CCI （P〉0.05） ;4） The effective rates of platelet transfusion in group A and B were 76.9% and 76.7%, respectively. Whic

关 键 词：冰冻单采血小板 新鲜单采血小板 临床应用疗效 CCI 

分 类 号：R457.14[医药卫生—治疗学] R331.143[医药卫生—临床医学]