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目的:探讨制备冰冻血小板的关键技术及其临床应用效果。方法:回顾性分析3257份冰冻血小板机采前献血员外周血小板数、开始冰冻时间、冻存保护剂注入速度和均匀度、存放形式、复融温度和水浴箱容量等制备条件对冰冻血小板质量的影响,通过检测150例输注冰冻血小板患者输注后1、24、48和72 h外周血的血小板计数和90例产科出血病人输注200份复融冰冻血小板后外周血小板数、血小板升高指数(CCI)、出血时间和血块收缩率等指标观察冰冻血小板临床应用的效果。结果:外周血小板数为(175-250)×10~9/L献血员的复融冰冻血小板絮状物明显减少(P<0.01)。DMSO注入过快且速度不匀、血袋多层存放、小容量水浴箱复融等因素均可明显降低冰冻血小板质量。常规保存0和3 d再冻存对血小板功能无影响。冻存时间1年内血小板回收率平均>80%。产科出血病人输注冰冻血小板后止血效果良好,未出现输血反应。冰冻血小板输入体内后立刻被消耗并发挥其功能,48 h后计数提升不佳。结论:机采前献血员外周血小板数量、保护剂注入速度和均匀度、存放血袋层数和复融水浴箱容量等均为影响冰冻血小板质量的关键因素。本研究制备的冰冻血小板临床应用效果良好。
Objective: To explore the key technology of preparing frozen platelets and its clinical application. Methods: Retrospective analysis of 3257 frozen platelet machine blood donors before peripheral blood platelet count, start freezing time, cryoprotectant injection speed and uniformity, storage mode, melting temperature and water bath capacity and other preparation conditions on the quality of frozen platelets By detecting the platelet count of peripheral blood in 150 patients with frozen platelet transfusion at 1, 24, 48 and 72 h after transfusion and the number of peripheral platelets, the platelet index (CCI), bleeding time and clotting rate and other indicators of clinical application of frozen platelet effect. Results: The amount of flocculated frozen platelets with peripheral blood platelets (175-250) × 10 ~ 9 / L decreased significantly (P <0.01). DMSO injection too fast and uneven speed, multi-layer storage of blood bags, small capacity water bath complex and other factors can significantly reduce the quality of frozen platelets. Routine preservation of 0 and 3 d re-freeze had no effect on platelet function. Platelet recovery within 1 year after cryopreservation averaged> 80%. Obstetric hemorrhage patients after transfusion of frozen platelets hemostatic effect is good, there is no transfusion reaction. Frozen platelets were consumed immediately after they were introduced into the body and exerted their functions, and the counts were not improved well after 48 hours. Conclusion: The number of peripheral blood platelets, the injection speed and uniformity of preservatives, the number of blood bag layers and the volume of reconstituted water bath are the key factors affecting the quality of frozen platelets. The clinical application of frozen platelets prepared in this study is effective.