Tarnower A, Clark D
University of New Mexico School of Medicine, Albuquerque.
Postgrad Med. 1989 Dec;86(8):48-51, 55-8, 63-5. doi: 10.1080/00325481.1989.11704495.
Transfusion medicine is an expanding subspecialty that continues to be reshaped and redefined. The current indications for red blood cell (RBC) transfusion are the presence of tissue hypoxia or a hemoglobin level of less than 7 g/dL. Platelet concentrates should be given prophylactically for severe thrombocytopenia secondary to production defects. In the patient who is in need of an invasive procedure or is bleeding, therapeutic platelet transfusion may be needed if the platelet count is less than 50,000/microL or the bleeding time is twice the upper limit of normal or more. Both RBC and platelet transfusion should be avoided if specific therapy is available for the underlying condition. Transfusion of fresh frozen plasma is indicated for reversal of inherited isolated coagulation factor deficiencies, emergent reversal of the effects of warfarin sodium (Coumadin, Panwarfin, Sofarin), antithrombin III deficiency, and thrombotic thrombocytopenic purpura. No blood transfusion is without risk to the recipient. Two of the major transfusion-related complications are alloimmunization and graft-versus-host disease. Techniques for preventing these conditions are available.
输血医学是一个不断发展的亚专业领域，仍在持续重塑和重新定义。目前红细胞（RBC）输血的指征是存在组织缺氧或血红蛋白水平低于7g/dL。对于因生成缺陷导致的严重血小板减少症，应预防性输注浓缩血小板。对于需要进行侵入性操作或正在出血的患者，如果血小板计数低于50,000/微升或出血时间是正常上限的两倍或更长，则可能需要进行治疗性血小板输注。如果针对基础疾病有特定治疗方法，应避免输注红细胞和血小板。新鲜冰冻血浆输注适用于遗传性孤立性凝血因子缺乏症的逆转、华法林钠（香豆素、泛华法林、索法林）作用的紧急逆转、抗凝血酶III缺乏症以及血栓性血小板减少性紫癜。任何输血对受者都有风险。两个主要的输血相关并发症是同种免疫和移植物抗宿主病。预防这些情况的技术是存在的。
