摘要
目的分析造血干细胞移植(hematopoietic stem cell transplantation,HSCT)患者围术期用血情况,提高移植患者输血保障能力。方法回顾性分析2020年4月—2023年6月137例HSCT患者围术期用血情况,其中自体HSCT(auto-HSCT)86例,异基因HSCT(allo-HSCT)51例。对比分析auto-HSCT和allo-HSCT、各病种之间及allo-HSCT不同供受者相容性情况下红细胞和血小板输注量的差异。结果137例HSCT患者中59例共输注红细胞483.7 U,其中auto-HSCT输注87.7 U(用血人数占比25/86),allo-HSCT输注396 U(34/51);125例共输注机采血小板592个治疗量,其中auto-HSCT输注207个治疗量(76/86),allo-HSCT输注385个治疗量(49/51)。Allo-HSCT血浆输注26560 mL(7/51),冷沉淀59.8 U(2/51)。Auto-HSCT与allo-HSCT患者红细胞输注量比较,差异有统计学意义(P<0.001);auto-HSCT与allo-HSCT患者血小板输注量,差异有统计学意义(P<0.001)。Auto-HSCT中多发性骨髓瘤、淋巴瘤、淀粉样变性患者红细胞输注量比较,差异无统计学意义(P>0.05);血小板输注量比较差异有统计学意义(P<0.05)。Allo-HSCT中白血病、再生障碍性贫血、骨髓增生异常综合征患者红细胞及血小板输注量比较,差异有统计学意义(P<0.05)。ABO血型主要不相合、次要不相合、主次要双向不合allo-HSCT中的红细胞、血小板输注量比较,差异无统计学意义(P>0.05)。Auto-HSCT与allo-HSCT患者粒系及巨核系植入时间比较,差异有统计学意义(P<0.05)。结论HSCT患者围术期用血情况个体差异较大,allo-HSCT需要更多输血支持。
Objective To analyze the perioperative blood use in patients with hematopoietic stem cell transplantation(HSCT)and improve the blood transfusion guarantee ability of transplantation patients.Methods The perioperative blood consumption of 137 patients with HSCT from April 2020 to June 2023 was retrospectively evaluated,and the differences of red blood cell and platelet transfusion between autologous transplantation(auto-HSCT),allogeneic transplantation(allo-HSCT),different diseases and different donor-recipient compatibility of allogeneic transplantation were compared and analyzed.Results A total of 483.7 U of red blood cells were transfused in 59 patients,87.7 U(25/86)in auto-HSCT and 396 U(34/51)in allo-HSCT.A total of 592 therapeutic doses of platelets were transfused in 125 patients,including 207 therapeutic doses of auto-HSCT(76/86)and 385 therapeutic doses of allo-HSCT(49/51).Allo-HSCT plasma infusion was 26560 mL(7/51),cryoprecipitate 59.8 U(2/51).The median red blood cell transfusion was significant difference in auto-HSCT patients and allo-HSCT patients(P<0.001).The platelet transfusion volume of auto-HSCT patients allo-HSCT patients was significant difference(P<0.001).There was no significant difference in red blood cell transfusion volume among multiple myeloma,lymphoma and amyloidosis patients in auto-HSCT(P>0.05).There was a significant difference in platelet transfusion volume(P<0.05).There were significant differences in the amount of red blood cell and platelet transfusion among leukemia,aplastic anemia and myelodysplastic syndrome(P<0.05).There was no significant difference in the amount of red blood cell and platelet transfusion in ABO blood group major incompatibility,minor incompatibility and major and minor bidirectional incompatibility allo-HSCT(P>0.05).There were significant differences in the time of granulocyte and megakaryocyte engraftment between auto-HSCT and allo-HSCT.Conclusion There are great individual differences in perioperative blood consumption in patients with HSCT.Allo-HSCT requires more blood transfusion support.
作者
周雪莹
张美玉
魏海潮
郑伟
ZHOU Xueying;ZHANG Meiyu;WEI Haichao;ZHENG Wei(Department of Transfusion Medicine,General Hospital of Northern Theater Command,Shenyang,110000,China;Department of Hematology,General Hospital of Northern Theater Command)
出处
《临床血液学杂志》
2025年第8期598-602,共5页
Journal of Clinical Hematology
基金
辽宁省科学技术基金项目(No:2022JH2/101500018)。
关键词
造血干细胞移植
红细胞输注
血小板输注
输血支持
hematopoietic stem cell transplantation
red blood cell transfusion
platelet transfusion
transfusion support
