• 中国科学论文统计源期刊
  • 中国科技核心期刊
  • 美国化学文摘(CA)来源期刊
  • 日本科学技术振兴机构数据库(JST)
临床输血与检验

临床输血与检验 ›› 2018, Vol. 20 ›› Issue (3): 242-245.DOI: 10.3969/j.issn.1671-2587.2018.03.006

• 单采治疗技术应用专题 • 上一篇    下一篇

血浆置换在临床危重疾病治疗中的安全性分析*

杨鹏,闻慧琴,卫玉芝,卞茂红,张循善   

  1. 230022 合肥，安徽医科大学第一附属医院
  • 收稿日期:2018-01-25 出版日期:2018-06-20 发布日期:2018-06-22
  • 作者简介:杨鹏 （1978–），男，安徽当涂人，副主任技师，副教授，博士，主要从事临床输血工作，（E-mail）yangpeng00812@163.com。
  • 基金资助:
    本课题受安徽省自然科学基金（No.1508085QH162）资助

The Safety of Therapeutic Plasmapheresis in Patients with Critical Diseases

YANG Peng，WEN Hui-qin，WEI Yu-zhi，et al.   

  1. Department of Blood Transfusion，the First Affiliated Hospital of Anhui Medical University，Heifei 230022
  • Received:2018-01-25 Online:2018-06-20 Published:2018-06-22

PDF

935

摘要： 目的 观察治疗性血浆置换术在血液系统、神经系统及内分泌代谢系统等危重疾病临床应用中的安全性问题。方法 回顾性分析本院2012年10月~2017年12月行血浆置换术的68例患者，观察患者围治疗期的不良反应，检测血浆置换治疗造成的血细胞丢失和溶血情况，分析10例患者保护性抗体HBsAb的滴度变化。结果 68例患者共进行了262次血浆置换治疗，33.8%的患者出现不同程度的不良反应，在262次血浆置换中不良反应率为16.8%，予以对症处理后短时间内缓解，并完成后续治疗；每次治疗造成的血细胞丢失少于1%血容量，未造成溶血；置换治疗结束的HBsAb滴度最多下降70%~80%，然后逐渐缓慢恢复。结论 大多数不良反应是轻微的、易于处理的；不会造成明显血细胞损失和溶血；治疗过程中HBsAb滴度始终在可检出水平之上；血浆置换术是一种安全、可接纳的治疗方法。

关键词: 治疗性血浆置换术, 不良反应, 安全性

Abstract: Objective To observe the safety of therapeutic plasma exchanges （TPE） in patients with critical diseases such as hematologic，neurologic，and metabolic disorders. Method Data of therapeutic plasma exchanges were collected in patients from Oct 2012 to Dec 2017. Detailed information of adverse events were recorded. Blood cell loss，hemolysis and changes of antibody titers were measured. Result Sixty-eight patients received 262 TPE treatments. Among them，33.8 percent of the patients were seen to have TPE related complications，with 16.8 percent of complication occurrence. After corresponding treatments，the adverse reactions were remitted immediately and follow-up treatments were completed. Blood loss of each TPE session was less than 1% of the patient’s total blood volume. No obvious hemolysis was noted in waste plasma bag. The maximum decrease in HBsAb was achieved on the final day of TPE sessions （70-80% reduction）. A slow return to baseline for HBsAb was observed. Conclusion The majority of complications were mild and manageable. The TPE may not cause obvious blood loss and hemolysis. HBsAb was detectable during the treatment. The TPE is a safe and well tolerated treatment option in several illnesses.

Key words: Therapeutic plasma exchanges , Adverse events , Safety

中图分类号: