血细胞分离单采术的应用及不良反应观察  

Application of therapeutic hemapheresis and the adverse reactions

作　　者：王琼 李晓芳 李露 何章勇[1] WANG Qiong;LI Xiaofang;LI Lu;HE Zhangyong(Department of Blood Transfusion,Chenzhou First People′s Hospital,Chenzhou 423000,China)

机构地区：[1]郴州市第一人民医院输血科,湖南郴州423000

出　　处：《中国输血杂志》2024年第10期1175-1179,共5页Chinese Journal of Blood Transfusion

基　　金：郴州市第一人民医院院内技术项目(2020C23)。

摘　　要：目的初步探讨血细胞分离单采术在临床治疗中的应用并观察不良反应。方法对121名患者应用某血细胞分离机进行126次治疗性血细胞分离单采术,根据患者不同的治疗需求选择不同的耗材和单采程序,分析临床治疗效果、监测实验室指标、观察治疗过程中的不良反应并采取相对应的措施。结果100名预行富血小板血浆(platelet-rich plasma,PRP)治疗的患者,采集成功率98%。采集出来的PRP血小板平均浓度达到(981.22±3.55)×10^(9)/L,血小板平均浓缩倍数可达到(4.01±0.52)倍,患者经PRP治疗后症状均有所改善;6名真性红细胞增多症患者和10名原发性血小板增多症患者经血细胞分离单采术联合羟基脲治疗后,前者的血红蛋白和红细胞计数均有所下降,后者的血小板数量下降,治疗前后差异有统计学意义(P<0.05)。5名患者进行了术前储存式自体输血,顺利完成手术。121名患者中,发生轻度献血反应10名(占比8.26%);穿刺部位出现淤青、血肿15名(占比12.40%);穿刺部位形成假性动脉瘤1名(占比0.83%)。结论血细胞分离单采术具有疗效好、成功率高、不良反应少等优点,可应用于PRP采集、治疗性去除血液病理成分、储存式自体输血等方面。Objective To discuss the application of therapeutic hemapheresis in clinical therapy and to observe the adverse reactions.Methods 121 patients underwent 126 times of therapeutic hemapheresis were performed in 121 patients by Nangel blood cell separator(NGL XCF 3000).Consumables and apheresis procedures were selected according to different treatment needs of patients.The clinical therapeutic efficacy laboratory indicators and adverse reactions during the treatment process were analyzed,and corresponding measures were taken.Results Among 100 patients who underwent platelet rich plasma(PRP)treatment,the success rate of collection was 98%.The average PRP platelet level achieved(981.22±3.55)×10^(9)/L,and the average concentration multiple of PRP achieved(4.01±0.52)times.All patients obtain symptomatic relief after treatment with PRP.The level of hemoglobin and red blood cell count of 6 polycythemia vera patients and the level of platelet of 10 essential thrombocythemia patients all decreased after therapeutic hemapheresis combined with hydroxycarbamide,with significant difference(P<0.05).Five patients with preoperative autologous blood donation have been through the surgery successfully.Out of the 121 patients,10(8.26%)experienced mild adverse reaction(8.26%),15(12.40%)showed bruising and bleeding at puncture site,and 1(0.83%)had pseudoaneurysm.Conclusion Therapeutic hemapheresis has the advantages of good curative effect,high success rate and low incidence of adverse reactions,and can be applied in PRP collection,removal of blood pathological components and preoperative autologous blood donation.

关 键 词：血细胞分离单采术 富血小板血浆 术前自体储血 

分 类 号：R457.12[医药卫生—治疗学]