| Objective:According to the laboratory data of the patients with blood diseases and clinical data for statistical analysis, explore blood disease patients with platelet transfusion refractoriness(PTR) incidence and blood disease patients with blood type, gender, age, type of blood disease platelet total transmission times of injection, red cells lost fluence, correlation(for example, fever, splenomegaly, DIC) complications, clinical correctly resolving platelet transfusion refractoriness to provide scientific basis. Methods:1. Choose December January 2012 to 2013 the 12 month period, in Tianjin First Central Hospital, Department of Hematology treatment and by clinical and laboratory diagnosis of hematological patients clinical data of a total of 70 cases, 39 male patients(56%), female 31 cases(44%). Their age ranged from 8 to 80 years old, median age 53 years old. 70 patients with hematologic diseases were infused with platelet in 318 case..2. The preparation of platelet infusion indications:(1) platelet < 20 x 109 / L, heavier bleeding; platelet > 20 x 109 but platelet < 40 x 109 / l also indicated that platelet transfusions should be;(2) skin petechia, ecchymosis, gingival bleeding, nose bleeding symptoms, to prophylactic infusion; retinal hemorrhage, menstrual capacity is more, hematuria, or intracranial hemorrhage patients should be given prophylactic infusion. The ABO blood group and Rh blood group were examined before transfusion of platelets, according to the same principle of ABO blood group(5- 0 days retention period)..3. Records of clinical parameters in patients with hematologic diseases, including medical physical examination and auxiliary examination: blood type blood disease, age, gender, disease type, erythrocyte transfusion, complications(infection, fever, splenomegaly, disseminated intravascular coagulation, platelet transfusion and infusion times), 1 hours before the blood transfusion and transfusion 24 hours after the injection of peripheral blood platelet count and platelet transfusions in patients with the number of CCI and PPR, were calculated, according to the clinical manifestations, determine the injection effect of platelet infusion in patients with hematologic diseases, analysis of gender, age, blood type, blood disease, erythrocyte transfusion, complications(infection, fever, splenomegaly, diffuse intravascular coagulation), the number of platelet transfusions and platelet transfusionrefractoriness incidence correlation. Results:1. According to the gender of the hematologic diseases were divided into two groups of male and female, will two groups of PTR incidence were compared. The difference is statistically significant(P < 0.05), indicating that PTR in patients with blood disease incidence rate was higher in females than in males.2. According to the clinical experience will 70 patients with hematological disease according to age, size divided into 4 groups(less than or equal to 30, 31 to 50 years old, 51 to 70 years > 70 years), the onset of all ages of PTR patients rate compared, the difference is statistically significant(P < 0.05).3. There was no obvious correlation between the 3 blood groups and the incidence of platelet transfusion in patients with hematologic diseases..4. The number of red blood cell transfusion was significantly different from that of 2000 ml group and red blood cell transfusion. The number of platelet transfusion in 2000 ml group was significantly different, the total amount of red blood cells was more, the probability of PTR was higher..5. Ineffective platelet transfusion rate and blood disease types: ITP patients with Al and AA patients compared with PTR rate, the difference were significant(x2 value 14.62 and 6.27 respectively, P < 0.05); and MDS patients with Al, AA and ITP patients, PTR rate difference was not significant(x2 values were 5.16, 1.76, and 1.51(P > 0.05). The incidence of AL in patients with MSD, AA, and PTR was significantly lower than that of ITP, which indicated that the effect of platelet transfusion was different for different blood diseases..6. Platelet transfusion refractoriness occurred rate and blood disease patients have no complications: Patients with hematologic complications and no complications PTR rate differences were significant(x 2 = 20.52, P < 0.05). The effect of platelet transfusion in patients with same type of blood disease without complication was better than that of patients with complication..7. Platelet transfusion refractoriness incidence and platelet transfusion injection times relation with no complications in patients with PTR rate with infusion of an increase in the number and increased(P < 0.05); there are complications in patients with hematological disease PTR occurrence rate of the patient’s platelet infusion times there was no correlation between(P > 0.05), the clinical symptoms of hemorrhage without significant changes. Conclusion:The results showed that the occurrence of platelet transfusion was related to many factors.:1. The incidence rate of female patients with platelet transfusion is higher than that of male patients with the disease of blood disease.2. With the increase of age, the incidence of platelet transfusion was significantly higher.3. There was no significant correlation between the 3 blood group differences and the incidence of platelet transfusion.4. The transfusion quantity of red blood cells influenced the invalid rate of platelet transfusion.5. The incidence of platelet transfusion was different in different types of blood diseases, which showed that the type of blood disease was related to platelet transfusion.6. The incidence of platelet transfusion was higher in the patients with hematological diseases than in the complication group and the incidence of platelet transfusion was higher than that of the non complication group.7. The incidence of PTR was increased with the increase of infusion times, the incidence of PTR was decreased, the incidence of the complication was not related to the number of the infusion.. |
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