摘要
目的回顾性分析紧急抢救时机采血小板ABO血型非同型输血情况及输血前后患者主要凝血指标的变化,探讨在紧急抢救情况下血小板非同型输血的临床应用价值。方法统计本院2016年11月—2018年5月实施机采血小板ABO非同型输血的病例资料,综合观察输血前后患者病情变化、凝血指标改善与否以及患者转归情况,对非同型输血效果进行评价。结果 17例患者共输注血小板21个机采单位,供者血型AB型11例、A型5例、B型4例及O型1例。输血前、后患者主要凝血指标Plt [(39.53±9.55)×10~9/L、(46.29±8.20)×10~9/L]、PT [(16.38±1.21)s、(15.08±0.85)s]和血栓弹力图凝血反应时间R [(8.39±0.58)min、(8.03±0.56)min]值比较无差异(P>0.05);APTT [(68.71±7.02)s、(53.34±4.31)s]和血栓最大幅度MA [(44.16±2.61)mm、(55.37±2.43)mm]输血前后比较有差异(P<0.05)。根据患者出血情况及凝血指标改善与否,综合评估血小板输注有效率70.58%,所有病例无输血不良反应发生。结论在紧急救治或抢救患者生命时,若无同型血小板储备或患者血型难以及时准确鉴定,进行非同型机采血小板输血可有效的改善患者凝血功能。
Objective To analyze retrospectively the changes of main coagulation indicators before and after the emergent transfusion of ABO-incompatible platelets obtained by pheresis,and to study the safety and clinical effectiveness of ABO-incompatible platelet transfusion under emergent circumstances.Methods The data of patients who received ABO-incompatible platelet transfusion in our hospital from November 2016 to May 2018 was collected.The changes of clinical conditions in patients before and after transfusion,the improvement of coagulation indicators,and the outcome of patients were monitored and evaluated.Results A total of 17 patients received 21 units of pheresis platelets collected from 11 donors with group AB,5 with group A,4 with group B,and 1 with group O.The main coagulation indicators of patients before and after transfusion were as follows:the Plt count increments(×10^9/L)were 39.53±9.55 vs 46.29±8.20,PT(s)was 16.38±1.21 vs 15.08±0.85,and R(min)was 8.39±0.58 vs 8.03±0.56,respectively.There were no significant differences between above pre-and post-transfusion indicators(P>0.05).However,such indicators as APTT(s)(68.71±7.02 vs 53.34±4.31)and MA(mm)(44.16±2.61 vs 55.37±2.43)had significant differences before and after transfusion(P<0.05).The efficiency of platelet transfusion was 70.58%based on the comprehensive evaluation of bleeding and improvement of coagulation indicators,and no adverse reactions after transfusion ever occurred.Conclusion In the case of emergent platelet transfusion when there is a short supply of group-specific platelets or difficulty in timely and accurate typing of the recipient's blood,the administration of ABO-incompatible platelets could effectively improve the coagulation function of the patients.
作者
林茹
王彦停
王辉亮
高长杰
LIN Ru;WANG Yanting;WANG Huiliang;GAO Changjie(Department of Blood Transfusion,Shengli Oilfield Central Hospital,Dongying 257034,China)
出处
《中国输血杂志》
CAS
2019年第4期352-354,共3页
Chinese Journal of Blood Transfusion
关键词
紧急抢救
血小板
非同型输血
emergency rescue
platelet
ABO-incompatible platelets
