摘要
目的:探讨制备冰冻血小板的关键技术及其临床应用效果。方法:回顾性分析3257份冰冻血小板机采前献血员外周血小板数、开始冰冻时间、冻存保护剂注入速度和均匀度、存放形式、复融温度和水浴箱容量等制备条件对冰冻血小板质量的影响,通过检测150例输注冰冻血小板患者输注后1、24、48和72 h外周血的血小板计数和90例产科出血病人输注200份复融冰冻血小板后外周血小板数、血小板升高指数(CCI)、出血时间和血块收缩率等指标观察冰冻血小板临床应用的效果。结果:外周血小板数为(175-250)×10~9/L献血员的复融冰冻血小板絮状物明显减少(P<0.01)。DMSO注入过快且速度不匀、血袋多层存放、小容量水浴箱复融等因素均可明显降低冰冻血小板质量。常规保存0和3 d再冻存对血小板功能无影响。冻存时间1年内血小板回收率平均>80%。产科出血病人输注冰冻血小板后止血效果良好,未出现输血反应。冰冻血小板输入体内后立刻被消耗并发挥其功能,48 h后计数提升不佳。结论:机采前献血员外周血小板数量、保护剂注入速度和均匀度、存放血袋层数和复融水浴箱容量等均为影响冰冻血小板质量的关键因素。本研究制备的冰冻血小板临床应用效果良好。
Objective:To explore the key technique for preparation of the frozen platelet and efficacy of its clinical application.Methods:The influences of the donators’ peripheral platelet count,starting time of freeze,injection rate and evenness of the freeze-protective agent,storage mode,re-melting temperature and the capacity of water-bath etc.on the quality of the frozen platelets were analyzed retrospectively in 3 257 samples of frozen platelets before platelet pheresis.Then,the platelet counts were examined in 150 cases transfused with frozen platelets at the time-points of 1,24,48 and72 hrs after transfusion,90 cases suffered from the obstetrical bleeding were transfused with 200 parts of the re-melting frozen platelets,and then the peripheral blood platelet count,platelet increasing index(CCI),bleeding time and blood clot retraction rate etc.were observed for determining the clinical efficiency of the frozen platelets.Results:The floccule in the re-melting frozen platelets from the donators with(175-250) ×10~9/L platelets were decreased significantly(P <0.01).The quality of frozen platelets was influenced by the following factors,such as injection of DMSO at a too fast and heterogeneous rate,blood bags stored in a multilamminar space,and re-melting in a water-bath of small capacity etc.The routine storage for 0 and 3 days did not influence the quality of the frozen platelets.The recovery rate of one year-freezing platelets all was higher than 80%.The effects of the frozen platelets transfused into the patients with obstetrical bleeding displayed good haemostatic results,and the blood transfusion reaction did not occur.However,the frozen platelets immediately were exhausted and displayed their function,but the counting after 48 hrs could not display a good effect of raising platelet number.Conclusions:The peripheral platelet count before platelet pheresis,the injection rate and evenness of the protective agent,the number of stratum for blood bags and the capacity of re-melting water-bath etc.all are the key facto
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2016年第4期1226-1231,共6页
Journal of Experimental Hematology
关键词
冰冻血小板
关键制备技术
质量控制
临床应用
frozen platelet
key preparation technique
quality control(QC)
clinical application
