自体血小板分离回输技术对于不同血小板水平的主动脉夹层患者成分血输注量的影响研究  

The Effect of Autologous Platelet Separation and Transfusion on Blood Transfusion Volume in Aortic Dissection with Different Platelet Levels

作　　者：李正业 王浩[1] 史玮 高海燕[1] 马现君[1] LI Zheng-ye;WANG Hao;SHI Wei(Department of Blood Transfusion,Qilu Hospital of Shandong University,Jinan,Shandong 250012)

机构地区：[1]山东大学齐鲁医院,250012

出　　处：《临床输血与检验》2022年第2期207-211,共5页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探讨自体血小板分离回输技术对于术前血小板数量在不同水平的患者,其血液保护作用是否一致,寻找主动脉夹层患者应用自体血小板分离回输技术的适用范围。方法回顾性分析2014年以主动脉夹层收入我院,并行象鼻式主动脉弓置换术的患者300例。将术中行自体血小板分离回输的患者设为实验组,未行该技术的患者设为对照组。按照术前血小板数量将实验组和对照组患者分为四个阶梯组:(100~150)×10^(9)/L,(150~200)×10^(9)/L,(200~250)×10^(9)/L,(250~300)×10^(9)/L。统计患者围手术期异体血小板、红细胞、血浆以及冷沉淀的输注量。结果本研究共纳入300例,患者一般情况(年龄,体重,身高,术前血小板计数),各阶梯组内实验组与对照组差异无统计学意义(P>0.05)。在四个阶梯组内,实验组患者围手术期异体血小板以及冷沉淀的输注量均比对照组下降(P<0.05)。术前血小板数量相对较低的患者,围手术期红细胞(PLT<200×10^(9)/L)和血浆(PLT<250×10^(9)/L)的输注量较对照组下降(P<0.05)。术前血小板数量相对较高的患者,其围手术期红细胞(PLT≥200×10^(9)/L)和血浆(PLT≥250×10^(9)/L)的输注量与对照组比较差异无统计学意义(P>0.05)。结论血小板分离回输技术,对于术前血小板数量在正常范围内的患者均可适用。而对于血小板数量在(100~200)×10^(9)/L区间内的患者更有意义,该技术可以减少其多种成分血的输注量,合理节约用血。Objective To explore whether the effect of autologous platelet separation and transfusion on patients with different platelet counts is similar to each other and to find the best application range of that in aortic dissection.Methods 300 patients with aortic dissection who accepted cardiac surgery in 2014 to 2019,with age arranged from 22 to 79 years and with weight from 50 to 85 kg,were divided into four grades according to preoperative platelet count:(100~150)×10^(9)/L,(150~200)×10^(9)/L,(200~250)×10^(9)/L,(250~300)×10^(9)/L.And each grade was randomly divided into two groups:control group and aPRP group(the patients received autologous PRP).The whole plateletpheresis process was completed before heperinization.Analyze the transfusion volume of allogeneic platelet,suspended red cells,plasma and cryoprecipitate of two groups during perioperative stage.Results There were no significant differences between control group and aPRP group in ages,weights,heights and PLT count before operation(P>0.05)in 300 patients.The amounts of allogeneic platelet and cryoprecipitate transfuesd was less in aPRP group than that in control group through four grades(P<0.05).The amounts of suspended red cells(PLT count<200×10^(9)/L)and plasma(PLT count<250×10^(9)/L)in aPRP groups were decreased significantly comparing with control groups(P<0.05).However,there was no significant differences in the transfusion volume of suspended red cells(PLT count≥200×10^(9)/L)and plasma(PLT count≥250×10^(9)/L)between aPRP and control groups(P>0.05).Conclusions In order to reduce the use of allogeneic platelets,autologous platelet separation and transfusion technology can be applied to patients with normal platelet count.For patients with platelets count in the range of(100~200)×10^(9)/L,autologous platelet separation and transfusion technology should be strongly recommended.It can significantly save blood products.

关 键 词：主动脉夹层 自体血小板采集 术前血小板数量 

分 类 号：R457[医药卫生—治疗学]