66例卡-梅现象患儿术前单次大剂量快速输注血小板时机探讨

doi:10.19438/j.cjoms.2022.01.009

中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (1): 48-51.doi: 10.19438/j.cjoms.2022.01.009

66例卡-梅现象患儿术前单次大剂量快速输注血小板时机探讨

胡光珍, 王新颖, 龚毓宾, 董长宪

河南省人民医院血管瘤科,河南省护理医学重点实验室,郑州大学人民医院,河南郑州 450003

收稿日期:2021-02-18 修回日期:2021-03-24 出版日期:2022-01-20 发布日期:2022-01-20
通讯作者: 董长宪,E-mail：zzchangxiand@126.com
作者简介:胡光珍（1969-）,女,本科,副教授,E-mail：13838220626@163.com
基金资助:
河南省医学科技攻关计划省部共建项目（SB201901070）

Timing of rapid transfusion of single large-dose platelet before operation in children with Kasabach-Merritt phenomenon

HU Guang-zhen, WANG Xin-ying, GONG Yu-bin, DONG Chang-xian

Department of Vascular Anomalies, Henan Provincial People's Hospital; Henan Provincial Key Laboratory of Nursing Medicine; People's Hospital of Zhengzhou University. Zhengzhou 450003, Henan Province, China

Received:2021-02-18 Revised:2021-03-24 Online:2022-01-20 Published:2022-01-20

摘要/Abstract

摘要： 目的: 探讨卡-梅现象（Kasabach-Merritt syndrome, KMP）患儿术前单次大剂量快速输注血小板的时机。方法: 回顾分析河南省血管瘤和脉管畸形诊疗中心2011年6月—2019年12月收治的66例KMP患儿,探讨术前不同时段单次大剂量快速输注血小板对术前1 h血小板的影响。其中,术前12⁺~24 h输注血小板患儿30例,术前6~12 h输注血小板患儿36例,均采用大剂量快速血小板输注,1/2~2/3治疗量,2~3 h之内快速输完。观察2组术前不同时段输注血小板对术前1 h血小板的纠正效果。采用SPSS 21.0 软件包对数据进行统计学分析。结果: 6~12 h组术前1 h血小板计数（platelet count,PLTC）均在正常范围,甚至高于正常范围;12⁺~24 h组有4例术前1 h PLTC低于正常范围;比较2组术前1 h PLTC及凝血4项,差异有统计学意义（P<0.05）;术后2组PLTC差异无统计学意义（P>0.05）。在整个血小板输注过程中,无并发症发生,输血前、后心率差异无统计学差异。结论: 术前6~12 h是KMP患儿术前大剂量快速血小板输注更安全、有效的时间段。

关键词: 卡-梅现象, 血小板减少, 输血时段, 婴幼儿

Abstract: PURPOSE: To investigate the timing of rapid transfusion of single large-dose platelet in children with Kasabach-Merritt syndrome (KMP) before surgery. METHODS: A retrospective analysis was performed on 66 children with KMP in our center from June 2011 to December 2019. The effects of rapid transfusion of single large-dose platelet at different time periods before surgery was determined. Among them, 30 children received platelet transfusion 12⁺-24 h before surgery and 36 children received platelet transfusion 6-12 h before surgery. All patients received transfusion of high-dose rapid platelet with 1/2-2/3 of the treatment volume, and the transfusion was completed within 2-3 h. The effect on platelet correction at 1 h before operation was compared between two groups. Statistical analysis was performed using SPSS 21.0 software package. RESULTS: The 1 h platelet count (PLTC) before operation in 6-12 h group was in the normal range, even higher than the normal range; 4 cases in 12⁺-24 h group had a 1 h PLTC lower than the normal range; the platelet and 4 coagulation indices at 1 h before operation was compared between the two groups, the difference in platelet count was statistically significant(P<0.05). The platelet count between the two groups after operation had no significant difference(P>0.05). During the whole platelet transfusion process, no complications occurred, and the difference in heart rate before and after transfusion was not statistically significant. CONCLUSIONS: Six to twelve hours before surgery is a safer and more effective period of rapid transfusion of single large-dose platelet in children with KMP.

Key words: Kasabach-Merritt syndrome, Thrombocytopenia, Blood transfusion period, Infants

中图分类号:

R782.05

胡光珍, 王新颖, 龚毓宾, 董长宪. 66例卡-梅现象患儿术前单次大剂量快速输注血小板时机探讨[J]. 中国口腔颌面外科杂志, 2022, 20(1): 48-51.

HU Guang-zhen, WANG Xin-ying, GONG Yu-bin, DONG Chang-xian. Timing of rapid transfusion of single large-dose platelet before operation in children with Kasabach-Merritt phenomenon[J]. China J Oral Maxillofac Surg, 2022, 20(1): 48-51.

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66例卡-梅现象患儿术前单次大剂量快速输注血小板时机探讨

Timing of rapid transfusion of single large-dose platelet before operation in children with Kasabach-Merritt phenomenon

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