血小板质量指数:它是降低新生儿重症监护病房血小板输注量的希望所在吗?

Platelet mass index: is it a hope for reduction of platelet transfusion in NICU?

作者信息

Yavuzcan Öztürk Dilek, Erçin Seçil, Gürsoy Tuğba, Karatekın Güner, Ovalı Fahri

机构信息

a Department of Neonatal Intensive Care , Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey and.

b Department of Pediatrics , Koc University School of Medicine , Istanbul , Turkey.

出版信息

J Matern Fetal Neonatal Med. 2016;29(12):1926-9. doi: 10.3109/14767058.2015.1067298. Epub 2015 Jul 14.

Abstract

OBJECTIVE

Thrombocytopenia is a very common problem in neonatal intensive care unit whose only specific treatment is platelet (PLT) transfusion which has well-known risks. Our aim is to test whether using PLT mass-based transfusion guideline would result in fewer transfusions or not.

METHODS

One hundred neonates with PLT count <100,000/μl were randomized into two groups: Group 1 (n = 50) was transfused according to PLT count-based guideline, whereas Group 2 (n = 50) was transfused according to PLT mass-based guideline. Subjects receiving one or more PLT transfusions and total number of PLT transfusions, hemorrhages, morbidity and mortality in both groups were recorded.

RESULTS

Demographic characteristics, PLT counts of the infants and clinical conditions associated with thrombocytopenia in both groups were not different. There was no reduction in the number of subjects receiving PLT transfusions (54% in Group 1, 50% in Group 2; p = 0.69) and in the number of PLT transfusions per infant (0.82 ± 1.13 versus 0.8 ± 1.23; p = 0.95). There was also no difference with respect to bleeding, morbidity and mortality between the groups.

CONCLUSION

Transfusion according to PLT mass or PLT count-based guideline does not seem to influence number of transfusions or the number of infants who were transfused.

摘要

目的

血小板减少症是新生儿重症监护病房中非常常见的问题,其唯一的特异性治疗方法是血小板(PLT)输注,而这种方法存在众所周知的风险。我们的目的是测试采用基于血小板质量的输血指南是否会减少输血次数。

方法

100例血小板计数<100,000/μl的新生儿被随机分为两组:第1组(n = 50)按照基于血小板计数的指南进行输血,而第2组(n = 50)按照基于血小板质量的指南进行输血。记录两组中接受一次或多次血小板输注的受试者、血小板输注的总数、出血情况、发病率和死亡率。

结果

两组婴儿的人口统计学特征、血小板计数以及与血小板减少症相关的临床情况均无差异。接受血小板输注的受试者数量(第1组为54%,第2组为50%;p =  0.69)和每个婴儿的血小板输注次数(0.82±1.13对0.8±1.23;p = 0.95)均未减少。两组在出血、发病率和死亡率方面也没有差异。

结论

按照基于血小板质量或血小板计数的指南进行输血似乎不会影响输血次数或接受输血的婴儿数量。

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