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目的分析登革热(DF)患者血小板输注有效性及合理性。方法回顾性分析本院2014年住院的805名登革热患者的临床资料及相关检验室数据,根据患者伴慢性病情况分为DF伴心脑血管疾病组(n=475)、DF伴其他慢性疾病组(n=229)和DF无伴慢性疾病组(n=101);按照患者极期Plt(×10~9/L)最低值情况分为最低>100组(n=78),最低50-100组(n=375)和最低<50组(n=352);依据患者是否输注血小板,分为输注组(n=81)和非输注组(n=271),将输注血小板患者按其输注前的Plt(×10~9/L)値,分<20组(n=58)和≥20组(n=23)。依据各组患者输注血小板前后的Plt、对患者血小板输注指征、病程及输注血小板情况做统计分析。结果 1)极期不同Plt(×10~9/L)最低值患者病程>100组与50-100组为:7.1±1.2 vs 8.5±1.9(P>0.05),<50组为13.8±6.1(P<0.05)。2)输注组和非输注2组DF患者Plt从极期最低值回升至100的恢复时间(d)分别为:5.2±1.1 vs 5.1±3.2(P>0.05);病程(d)分别为:9.2±4.3 vs 8.9±4.5(P>0.05)。3)极期DF患者Plt(×10~9/L)平均输注量(U)<20组和≥20组分别为1.2±0.3 vs 2.1±0.2(P<0.05);出血率分别为5.2%(3/58)vs 4.3%(1/23)(P>0.05);输血反应过敏反应、发热率分别为6.9%(4/58)vs 10.3%(6/58)vs 13.0%(3/23)17.4%(4/23)(P<0.05);输注无效发生率为5.2%(3/58)vs 4.3%(1/23)(P>0.05)。结论 DF患者血小板减少的程度与感染的严重程度相关,输注血小板对患者血小板恢复和病程无影响。
Objective To analyze the effectiveness and rationality of platelet transfusion in patients with dengue fever (DF). Methods The clinical data and laboratory data of 805 dengue patients hospitalized in 2014 were retrospectively analyzed. According to the patients with chronic diseases, they were divided into DF with cardiovascular disease group (n = 475), DF with other chronic diseases group (n = 229) and DF uncoordinated chronic diseases group (n = 101). Patients in the lowest PIt (× 10 ~ 9 / L) (n = 375) and the lowest (n = 352). According to whether patients were transfused into platelets, they were divided into infusion group (n = 81) and non-infusion group Before infusion, Plt (× 10 ~ 9 / L) 値, <20 groups (n = 58) and ≥20 groups (n = 23). According to each group of patients before and after transfusion platelet Plt, the indication of patients with platelet transfusion, duration and platelet transfusion do statistics. Results 1) The duration of patients with the lowest Plt (× 10 ~ 9 / L) in the extreme period was> 7.1 ± 1.2 vs 8.5 ± 1.9 (P> 0.05) in the 100 and 50-100 groups, and was 13.8 ± 6.1 P <0.05). 2) The recovery time (d) of Plt from the lowest period to the end of the period of 100% in infusion group and non-infusion group DF patients were 5.2 ± 1.1 vs 5.1 ± 3.2 (P> 0.05); the duration of disease (d) : 9.2 ± 4.3 vs 8.9 ± 4.5 (P> 0.05). 3) The average Plt (× 10 ~ 9 / L) infusion volume (U) in extreme DF group was 1.2 ± 0.3 vs 2.1 ± 0.2 (P <0.05) respectively in less than 20 and more than 20 groups; the bleeding rates were 5.2% (3/58) vs 4.3% (1/23), respectively (P> 0.05). The incidence of allergic reactions in transfusion reaction were 6.9% (4/58) vs 10.3% (6/58) vs 13.0% (3/23) ) Were 17.4% (4/23) (P <0.05). The incidence of ineffective infusion was 5.2% (3/58) vs 4.3% (1/23) (P> 0.05). Conclusion The degree of thrombocytopenia in patients with DF is related to the severity of infection. Platelet transfusion has no effect on platelet recovery and duration of disease.