血液病患者血小板输注效果评价及影响因素分析

目的探讨血小板输注在防治血液病患者出血中的有效性及其影响因素。方法对68例反复输血治疗的血液病患者给予机采血小板输注,输注后24h进行外周血血小板计数,根据血小板回收率(PPR)和血小板增高指数(CCI)判定输注效果并讨论其影响因素。结果(1)急性白血病(AL)、再生障碍性贫血(AA)、特发性血小板减少性紫癜(ITP)和骨髓异常增生综合征(MDS)患者血小板输注有效率分别为88·9%(153/172)、83·1%(59/71)、51·3%(19/37)和68·8%(11/16),4种类型的血液病患者血小板输注有效率间差别有显著性意义(P<0·05);(2)AL、AA、ITP无并发症患者血小板输注有效率与同病种有并发症患者比较,差别有显著性意义(P<0·05);(3)无并发症组患者血小板输注有效率随输注次数的增加而下降(P<0·05),而有并发症组患者血小板输注有效率与输注次数关系不大(P>0·05)。结论输注血小板是预防和治疗因血小板减少或血小板功能障碍而引起的出血的最有效措施,输注次数、发热、脾肿大、弥散性血管内凝血(DIC)等因素影响血小板的输注效果。

Curative Effects of Platelet Transfusion and Its Influence Factors in Patients with Hematologic Diseases

Objective To explore the efficacy and influence factors of platelet transfusion in the prevention and cure of patients with hematologic diseases from bleeding.Methods The engine picked platelet were transfused to 68 patients.Peripheral blood platelet count was made at 24 hours after platelet transfusion.The effectiveness was assayed by correct countincrement (CCI) and percentage platelet recovery (PPR),then the influence factors were analyzed.Results (1)The effective rate of acute leukemia (AL),aplasticanemia (AA),idiopathic throbocytopenic purpura (ITP) and myelodysplastic syndrome (MDS) were 88.9%(153/172),83.1%(59/71),51.3%(19/37) and 68.8%(11/16) respectively(P<0.05).(2)The effective rate of patients with no complications in AL,AA,ITP group were higher than those with complications(P<0.05).(3)In non complications group,the effective rate decreased with the frequency of platelet transfusion increasing.Conclusion Platelet transfusion is an effective procedure to prevent and cure bleeding in thrombocytopenia.Fever,frequency of platelet transfusion,splenomegaly and disseminated inravascular coagulation are some important influence factors.