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[造血系统疾病血小板输注的现状与问题:问卷调查结果]

[Current status and problem of platelet transfusion for hematopoietic diseases: results from a questionnaire survey].

作者信息

Kato Hidefumi, Handa Makoto, Takamoto Shigeru

机构信息

Department of Transfusion Medicine, Aichi Medical University.

出版信息

Rinsho Ketsueki. 2006 Dec;47(12):1514-20.

Abstract

We carried out a survey on platelet transfusions performed in hospitals certified by the Japanese Society of Hematology. The average values of the pretransfusion platelet count (trigger value) for the day on which the transfusion was ordered, and the values on each day in the interval between the order and actual transfusion, were compared with the Guidelines. The average trigger value in aplastic anemia and myelodysplastic syndrome patients (A group) (1.41 x 10(4)/microl) for the same day on which the transfusion was ordered was higher than the Guideline, whereas those patients with hematological disorders undergoing chemotherapy (B group) and hematopoietic stem cell transplantation (C group), namely 2.08 x 10(4)/microl and 2.1 x 10(4)/microl, respectively, were acceptable values when compared with the Guidelines. On the other hand, in all groups, the transfusion trigger values at one or two days after ordering were higher than the Guidelines, being 2.56 x 10(4)/microl in the A group, 3.15 x 10(4)/microl in the B group, and 2.59 x 10(4)/microl in the C group. We have tried to formulate platelet count criteria for ordering a transfusion based on one day before the actual transfusion, because these platelet counts on ordering were relatively high. The criteria are 1.0-1.5 x 10(4)/microl in group A, 3.0 x 10(4)/microI in group B, and 3.0 x 10(4)/microl in group C. In order to perform platelet transfusion according to the Guidelines, the platelet count on ordering should be decreased as we proposed.

摘要

我们对日本血液学会认证的医院中进行的血小板输注情况进行了一项调查。将输血医嘱开具当天的输血前血小板计数(触发值)的平均值,以及医嘱开具至实际输血期间各天的数值,与指南进行了比较。再生障碍性贫血和骨髓增生异常综合征患者(A组)在输血医嘱开具当天的平均触发值(1.41×10⁴/微升)高于指南值,而接受化疗的血液系统疾病患者(B组)和造血干细胞移植患者(C组),分别为2.08×10⁴/微升和2.1×10⁴/微升,与指南相比是可接受的值。另一方面,在所有组中,医嘱开具后1天或2天的输血触发值均高于指南值,A组为2.56×10⁴/微升,B组为3.15×10⁴/微升,C组为2.59×10⁴/微升。由于这些医嘱开具时的血小板计数相对较高,我们试图根据实际输血前1天制定输血医嘱的血小板计数标准。标准为A组1.0 - 1.5×10⁴/微升,B组3.0×10⁴/微升,C组3.0×10⁴/微升。为了按照指南进行血小板输注,应如我们所提议的那样降低医嘱开具时的血小板计数。

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