滤除白细胞输血技术在临床输血中的应用效果分析  

Clinical application effects of leukocyte-filtered blood transfusions

作　　者：陈秀明 Chen Xiuming(Department of Blood Transfusion,the First People's Hospital of Yongkang,Yongkang 321300,Zhejiang Province,China)

机构地区：[1]永康市第一人民医院输血科,永康321300

出　　处：《中国基层医药》2022年第2期217-220,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省医学会临床科研基金项目(2013ZYC-A125)。

摘　　要：目的探讨滤除白细胞输血技术在临床输血中的应用效果。方法选取永康市第一人民医院2017年1月至2018年12月收治的需大量输血的大出血患者120例,根据就诊单双号分为两组各60例。对照组按规范直接输血,观察组滤除白细胞后再输血,比较两组凝血功能指标、血液流变学指标、细胞免疫功能指标、免疫球蛋白指标、体温、非溶血性发热性输血反应发生率。结果输血后,观察组凝血酶原时间、活化部分凝血活酶时间、凝血酶时间分别为(12.39±1.41)s、(26.84±6.47)s、(14.32±3.14)s,均短于对照组的(15.54±2.03)s、(34.23±7.59)s、(20.98±4.27)s(t=9.872、5.740、9.733,均P<0.05);观察组红细胞比容、红细胞沉降率、血浆黏度分别为(39.28±2.17)%、(25.97±4.10)mm/h、(2.19±0.45)mp·s,对照组分别为(34.64±4.52)%、(21.85±3.64)mm/h、(1.76±0.42)mp·s,两组差异均有统计学意义(t=9.87、5.74、9.73,均P<0.05);对照组输血前后CD_(3)^(+)、CD_(4)/CD_(8)、免疫球蛋白G、免疫球蛋白A、免疫球蛋白M差异均有统计学意义(t=5.99、5.91、5.77、5.80、5.85,均P<0.05),观察组差异均无统计学意义(均P>0.05);观察组体温为(36.58±0.50)℃,低于对照组的(37.16±0.57)℃(t=5.95,P<0.05);观察组非溶血性发热性输血反应发生率为1.67%,低于对照组的13.33%(χ^(2)=5.88,P<0.05)。结论滤除白细胞用于输血中,可有效恢复患者的体温,改善其凝血功能和血液流变学指标,减轻输血对患者免疫功能、体温的影响,减少非溶血性发热性输血反应。Objective To investigate the clinical application effects of leukocyte-filtered blood transfusions.Methods A total of 120 patients with massive bleeding who received transfusions of a large amount of blood in the First People's Hospital of Yongkang,China from January 2017 to December 2018 were included in this study.They were divided into a control group(even numbers)and an observation group(odd numbers)according to registration numbers.The control group was subjected to direct blood transfusion.The observation group was given leukocyte-filtered blood transfusions.Coagulation function index,hemorheological index,cellular immune function,immunoglobulin level,body temperature,and the incidence of febrile non-hemolytic transfusion reactions were compared between the two groups.Results After blood transfusions,prothrombin time,activated partial thromboplastin time,thrombin time in the observation group were(12.39±1.41)seconds,(26.84±6.47)seconds,and(14.32±3.14)seconds,which were significantly shorter than those in the control group[(15.54±2.03)seconds,(34.23±7.59)seconds,(20.98±4.27)seconds,t=9.872,5.740,9.733,all P<0.05].Hematocrit,erythrocyte sedimentation rate,and plasma viscosity in the observation group were(39.28±2.17)%,(25.97±4.10)mm/h,and(2.19±0.45)mp·s respectively,and those in the control group were(34.64±4.52)%,(21.85±3.64)mm/h,and(1.76±0.42)mp·s respectively.There were significant differences in these indices between the two groups(t=9.87,5.74,9.73,all P<0.05).There were significant differences in CD_(3)^(+),CD_(4)/CD_(8),immunoglobulin G,immunoglobulin A,and immunoglobulin M between before and after blood transfusions in the control group(t=5.99,5.91,5.77,5.80,5.85,all P<0.05).There were no significant differences in these indices between before and after blood transfusions in the observation group(all P>0.05).After blood transfusions,body temperature was significantly lower in the observation group than in the control group[(36.58±0.50)℃vs.(37.16±0.57)℃,t=5.95,P<0.05].The incidence o

关 键 词：输血 滤除白细胞 凝血功能 血液流变学 非溶血性发热性输血反应 免疫球蛋白 免疫功能 安全性 

分 类 号：R457.1[医药卫生—治疗学]