两种血小板制剂应用于儿科血液病的临床观察

目的观察并比较机器单采法及手工法分离制备血小板制剂用于儿科血液病输注的效果。方法输注机器单采血小板患儿463例次为机采制剂组,输注手工分离血小板制剂患儿155例次为手工制剂组,分别在输注后24、48及72h作外周血血小板计数,观察临床止血效果、有无输血反应发生,计算血小板计数增加校正指数(CCI)、血小板回升率(PPR)、输注无效率、输血反应发生率等指标。结果输注后24、48、72h,机采制剂组:CCI分别为18.9、15.4、14.1,PPR分别为33.4%、27.8%、25.0%;手工制剂组:CCI分别为11.3、9.4、2.9,PPR分别为20.3%、10.3%、3.8%;机采法制剂组均明显高于手工制剂组(P<0.01)。机采制剂组输注无效率10.58%、输血反应发生率3.02%,手工制剂组相应为32.90%及11.61%,机采组虽都明显低于手工组,但两组均达到较好的临床止血目的,组间无差异。结论输注机器单采血小板制剂能更有效地提高血液病患儿的血小板值,减少其血小板输注无效及输血反应的发生。

Effectiveness of transfusion of whole blood derived platelets compared to apheresis platelets

Objective To compare the clinical effectiveness of whole blood derived platelets and apheresis platelets in children with hematological diseases.Methods Children were divided into two groups: apheresis platelet group(463 children) and whole-blood-derived platelet group(155 children).The platelet corrected count increment(CCI),percentage platelet recovery(PPR),the incidence rate of post-transfusion refractoriness to platelets(PTR) and adverse reaction were observed and assayed at 24,48 and 72hours after transfusion.Results In the apheresis platelet group,CCI and PPR at 24,48,and 72 hours after transfusion were significantly higher(P<0.01),which were 18.9% and 15.4%,14.1% and 33.4%,27.8% and 25.0%,respectively.The incidence rate of PTR and adverse reaction in apheresis group were 10.58% and 3.02%,respectively,which were lower than those of whole-blood-derived platelet group.Both groups could achieve hemostasis quickly.Conclusion Apheresis platelets have higher CCI,and low incidence rate of PTR and less adverse transfusion reaction,compared to whole blood derived platelet concentrates.