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血小板减少症患儿预防性血小板输注值的探讨
Evaluation of Threshold for Prophylactic Platelet Transfusions in Patients with Pediatrics Thrombocytopenia
【作者】 王琴;
【导师】 严媚;
【作者基本信息】 新疆医科大学 , 儿科学, 2010, 硕士
【摘要】 目的:探讨非免疫性血小板减少症患儿预防性血小板输注值,以了解观察组以10×10~9 /L为输注值时是否与传统输注值20×10~9 /L同样可以达到预防出血、止血的目的,是否同样安全有效。方法: 2008年12月至2010年3月我科患有非免疫性血小板减少症的患儿住院晨起监测血常规,将需预防性输注血小板的患儿分为A、B两组, A组即对照组,输注值plt≤20×10~9 /L;B组即观察组,输注值plt≤10×10~9 /L,当各组低于上述输注值时及时给予预防性血小板输注,并比较两组输注血小板的次数、性别、民族、病种、出血情况、输血小板次数、输血小板量、临床出血症状的改善及控制情况、输血小板的不良反应。结果: A、B两组的性别、民族、病种比较均无统计学意义,A、B两组轻微出血事件发生率比较有统计学差异,严重出血事件比较无统计学差异,A、B两组输血小板次数、输血小板量比较差别无统计学意义, A、B两组临床出血症状大部分得到改善及有效控制,A、B两组组内比较输血小板前后临床出血分级比较有统计学意义,A、B两组输血小板不良反应发生率无统计学意义。结论: A、B两组患儿在无侵袭性操作的情况下,采用plt≤10×10~9 /L作为预防性血小板输注值是安全的。
【Abstract】 Objective: To evaluate the threshold for prophylactic platelet transfusions in patients with non--immune thrombopenia of childhood. To observe that if the transfusion of 10×10~9 /L of the control group is safe and effient to guand against hemorrhage and hemostasis to the original transfusion of 20×10~9/L . Methods:We evaluated during the period of December, 2008-March, 2010 in our division , in the early blood routine test of non--immune thrombocytopenia childhood patients. The patients who need prophylactic platelet transfusions was divided into two groups, group A was control group (the control arm in which the subjects were given platelets if the morning platelet count was less than 20×10~9/L or if bleeding) , and the group B was observation group (which included subjects who received platelet if the morning count of platelet was lower than 10×10~9/L), compare the frequency and quantity of the platelet transfusions、sexes、nationality、the type of sickness、bleeding situation、the improvement and control of clinical bleeding symptom、and the rates of adverse reactions of platelet transfusions. Results:First, the two groups had no distinct differences in the sexes、nationality、the type of sickness ,and the quantity、the frequency of platelet transfusions, too. Second, the light bleeding events were significantly different between group A and group B, the severe bleeding events were not significantly different between group A and group B, and the clinical bleeding symptom had been effectively controlled and improved. Third, the rates of adverse reactions of platelet transfusions were not significantly different between group A and group B. Conclusion:The childhood patients of group A and group B who under no invasive procedures by a 10×10~9 /L prophylactic platelet transfusion is safe.
【Key words】 Thrombopenia; Prophylactic platelet transfusion; Threshold;