重症患者血小板输注的临床研究

目的：探明重症患者血小板（PLT）减少的发生率及PLT输注的目的、指征、效果以及血小板减少对患者预后的影响。方法：采用回顾性方法分析临床资料,血小板减少定义为PLT〈100×109/L,根据PLT减少的程度分为轻度减少,PLT〈100×109/L;中度减少,PLT〈50×109/L;重度减少,PLT〈20×109/L。结果：53.4%（206例）重症患者住院期间曾出现PLT〈100×109/L,与PLT未减少患者相比PLT减少患者有较高的死亡率（P〈0.05）,需要输注较多的血小板（P〈0.05）、新鲜冰冻血浆（P〈0.05）和红细胞（P〈0.05）。结论：约50%重症监护病房住院患者在住院过程中出现过PLT〈100×109/L,血小板减少患者需要较多的输血支持,有较高的死亡率。

Clinical research on platelet transfusion in critical patients

Objective：To investigate the incidence of thrombocytopenia and the impact of thrombocytopenia on prognosis for intensive care unit （ICU） critical patients.Method：Retrospective analysis was performed on the clinical data. Thrombocytopenia was defined as a platelet count of less than 100×109/L and medium and severe thrombocytopenia as a platelet count of less than 50-100×109/L and 50×109/L,respectively.Result：Of the 386 patients,206 （53.4%） had thrombocytopenia. Patients who developed a platelet count of less than 100×109/L had higher mortality （P0.05）,and were more likely to receive platelets （P0.05）,fresh frozen plasma （P0.05）,and red blood cell transfusion （P0.05） than patients who did not develop thrombocytopenia.Conclusion：About 50% of patients admitted to ICU had at least one platelet count of less than 100×109/L during their ICU stay. Patients who developed thrombocytopenia were more likely to die and to require more blood product transfusion.