66例卡-梅现象患儿术前单次大剂量快速输注血小板时机探讨  

Timing of rapid transfusion of single large-dose platelet before operation in children with Kasabach-Merritt phenomenon

作　　者：胡光珍 王新颖 龚毓宾 董长宪 HU Guang-zhen;WANG Xin-ying;GONG Yu-bin;DONG Chang-xian(Department of Vascular Anomalies,Henan Provincial People's Hospital,Henan Provincial Key Laboratory of Nursing Medicine,People's Hospital of Zhengzhou University.Zhengzhou 450003,Henan Province,China)

机构地区：[1]河南省人民医院血管瘤科,河南省护理医学重点实验室,郑州大学人民医院,河南郑州450003

出　　处：《中国口腔颌面外科杂志》2022年第1期48-51,共4页China Journal of Oral and Maxillofacial Surgery

基　　金：河南省医学科技攻关计划省部共建项目(SB201901070)。

摘　　要：目的:探讨卡-梅现象(Kasabach-Merritt syndrome,KMP)患儿术前单次大剂量快速输注血小板的时机。方法:回顾分析河南省血管瘤和脉管畸形诊疗中心2011年6月—2019年12月收治的66例KMP患儿,探讨术前不同时段单次大剂量快速输注血小板对术前1 h血小板的影响。其中,术前12+~24 h输注血小板患儿30例,术前6~12 h输注血小板患儿36例,均采用大剂量快速血小板输注,1/2~2/3治疗量,2~3 h之内快速输完。观察2组术前不同时段输注血小板对术前1 h血小板的纠正效果。采用SPSS 21.0软件包对数据进行统计学分析。结果:6~12 h组术前1 h血小板计数(platelet count,PLTC)均在正常范围,甚至高于正常范围;12+~24 h组有4例术前1 h PLTC低于正常范围;比较2组术前1 h PLTC及凝血4项,差异有统计学意义(P<0.05);术后2组PLTC差异无统计学意义(P>0.05)。在整个血小板输注过程中,无并发症发生,输血前、后心率差异无统计学差异。结论:术前6~12 h是KMP患儿术前大剂量快速血小板输注更安全、有效的时间段。PURPOSE:To investigate the timing of rapid transfusion of single large-dose platelet in children with Kasabach-Merritt syndrome(KMP)before surgery.METHODS:A retrospective analysis was performed on 66 children with KMP in our center from June 2011 to December 2019.The effects of rapid transfusion of single large-dose platelet at different time periods before surgery was determined.Among them,30 children received platelet transfusion 12+-24 h before surgery and 36 children received platelet transfusion 6-12 h before surgery.All patients received transfusion of high-dose rapid platelet with 1/2-2/3 of the treatment volume,and the transfusion was completed within 2-3 h.The effect on platelet correction at 1 h before operation was compared between two groups.Statistical analysis was performed using SPSS 21.0 software package.RESULTS:The 1 h platelet count(PLTC)before operation in 6-12 h group was in the normal range,even higher than the normal range;4 cases in 12+-24 h group had a 1 h PLTC lower than the normal range;the platelet and 4 coagulation indices at 1 h before operation was compared between the two groups,the difference in platelet count was statistically significant(P<0.05).The platelet count between the two groups after operation had no significant difference(P>0.05).During the whole platelet transfusion process,no complications occurred,and the difference in heart rate before and after transfusion was not statistically significant.CONCLUSIONS:Six to twelve hours before surgery is a safer and more effective period of rapid transfusion of single large-dose platelet in children with KMP.

关 键 词：卡-梅现象 血小板减少 输血时段 婴幼儿 

分 类 号：R782.05[医药卫生—口腔医学]