Söhngen D, Schneider W
Medizinische Klinik und Poliklinik, Heinrich-Heine-Universität, Düsseldorf.
Klin Wochenschr. 1991 Jun 18;69(9):379-86. doi: 10.1007/BF01647409.
Thrombocytopenia is the most common cause of bleeding tendency, and, if due to impaired platelet production, is best treated by platelet transfusions. Prophylactic transfusions for asymptomatic patients should be considered if platelet count is below 20,000/microliters. However, if bleeding occurs or surgery is inevitable, platelet count should be maintained above 50,000/microliters. The benefit of platelet transfusions has to be balanced against risks like fever, infections and haemolysis. The effectiveness of platelet transfusions should be examined after 1 and 24 hrs by measuring the corrected count increment (CCI). Not only alloimmunization is a reason for unsatisfactory platelet increments. A poor CCI can also be due to fever, sepsis, hepato-splenomegaly or special drugs, which must be taken into account when assessing the demand for platelet transfusions.
血小板减少是出血倾向最常见的原因,若因血小板生成受损所致,最佳治疗方法是输注血小板。若血小板计数低于20,000/微升,对于无症状患者应考虑预防性输血。然而,若发生出血或手术不可避免,血小板计数应维持在50,000/微升以上。输注血小板的益处必须与发热、感染和溶血等风险相权衡。输注血小板1小时和24小时后,应通过测量校正计数增加值(CCI)来检查其有效性。血小板增加值未达预期不仅是同种免疫所致。CCI不佳也可能是由于发热、脓毒症、肝脾肿大或特殊药物引起,在评估血小板输注需求时必须考虑这些因素。