| BackgroundEither the pathological condition of the disease or relevant medications increase the risks of thrombocytopenia and bleeding in patients with blood system diseases,posing a huge threat to the survival.Prophylactic platelet(PLT)transfusion is the main clinical approach to reduce the risks of thrombocytopenia and bleeding.However,bleeding is a consequence resulted from diverse causes.Clinical prophylactic transfusion guided only by the platelet count presents some disadvantages.Currently,thromboelastography(TEG)in guiding preventive platelet transfusion has been recommended in relevant clinical guidelines,which can dynamically evaluate the whole process of coagulation in a graphical way,thus enhancing the accuracy and efficacy.This study aims to assess the bleeding risk of patients through TEG-related parameters and the platelet count.We explored the threshold of platelet transfusion,and hoped to guide clinical apheresis platelet transfusion.ObjectiveThis experiment analyzes the relationship between the main parameters of TEG,the platelet count and clinical bleeding in patients with blood diseases.We explore the threshold of the relevant parameters in the pathological condition of bleeding,aiming to scientifically guiding the clinical apheresis platelet transfusion.MethodsA total of 224 thrombocytopenia patients hospitalized in the Department of Hematology of our hospital from June 2018 to May 2020 were recruited.They were categorized into 5groups according to the platelet counts as follows:Group A,(0-10)×10~9/L;Group B,(11-20)×10~9/L;Group C,(21-30)×10~9/L;Group D,(31-50)×10~9/L;and Group E,(51-100)×10~9/L.TEG was performed in each patient for assessing the main parameters of TEG and platelet counts among groups.Their differences between bleeding patients and non-bleeding patients were also examined,so as to guide the clinical need for preventive apheresis platelet transfusion.Results1.Maximal amplitude(MA)in group A,B and C increased gradually,and the difference between the two groups was statistically significant(P<0.05);2.There were no significant difference in Angle between adjacent groups(P>0.05);3.There were no significant difference in kinetics(K)between adjacent groups(P>0.05);4.The reaction time(R)has a statistically significant difference between group D and group E(P<0.05);5.In group A,the number of bleeding patients with an MA value less than 43 mm was significantly higher than those with an MA value greater than 43 mm,and the difference was statistically significant(P<0.05);6.In group B,the number of bleeding patients with an MA value less than 40 mm was significantly higher than those with an MA value greater than 40 mm,and the difference was statistically significant(P<0.05);7.In group C,the number of bleeding patients with an MA value less than 38 mm was significantly higher than those with an MA value greater than 38 mm,and the difference was statistically significant(P<0.05);8.In group D,the number of bleeding patients with an MA value less than 35 mm was significantly higher than those with an MA value greater than 35 mm,and the difference was statistically significant(P<0.05);9.In group E,the number of bleeding patients with an MA value of less than 50 mm was significantly higher than those with an MA value of greater than 50 mm,and the difference was a statistically significant(P<0.05);Conclusions1.There is a strong consistency between the platelet count and MA value,and we believed that the platelet count is a promising reference index for preventive platelet transfusion.2.The risk of bleeding differs in the different ranges of platelet count,so as the MA threshold for preventive platelet transfusion.Preventive platelet transfusion is recommended following the corresponding values of platelet count combined with MA:(0-10)×10~9/L—43mm,(11-20)×10~9/L—40 mm,(21-30)×10~9/L—38 mm,and(31-50)×10~9/L—35 mm.TEG is not recommended for guiding preventive platelet transfusion. |
PDF Full Text Request