治疗性血浆置换后24小时内的并发症

Jyoti Bharti, Tulika Chandra, Archana Solanki, Ashutosh Singh, D. Himanshu Reedy, Mallika Agarwal
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摘要

背景:治疗性血液分离是去除血液中的病理成分或调节细胞功能。通过这项研究,我们观察到治疗性血浆置换(TPE)后24小时内的并发症与患者的人口统计学特征和程序变化有关。方法:输血医学系与印度勒克瑙乔治国王医科大学医学系合作开展为期一年的前瞻性观察研究。结果:本组共60例,共150个TPE周期。咳嗽和呕吐患者的最大平均年龄(36±4)岁,采血部位感染患者的最大平均BMI(36.34±5.09)岁。呕吐时血红蛋白平均变化最大(2.28±0.00),其次为内出血。咳嗽组活化部分凝血活素时间(aPTT)平均变化最大(22.05±0.34),呕吐组次之。低温组凝血酶原时间(PT)平均变化最大(13.16±10.47),其次为内出血。腹部不适时S.肌酐平均变化最大(0.23±1.54),其次为呕吐。咳嗽组收缩压(SBP)平均变化最大(7.00±5.20),其次为双足水肿。死亡时观察到SpO2的最大平均变化。结论:术后24小时内并发症以男性腹部不适为主,与体重指数(BMI)相关。我们观察到并发症与APTT、PT、s尿素、s肌酐、脉搏、收缩压、SpO2和BMI呈显著正相关。这强调了并发症随周期数的增加而减少的趋势。
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Complications after therapeutic plasma exchange within 24 hours
Background: By therapeutic apheresis is to remove a pathologic element from blood or to modulate cellular function. By this study we observed, complications after the therapeutic plasma exchange (TPE) within 24 hours with respect to patient’s demographic profiles and procedural variations. Methods: One-year prospective observational study conducted by the Department of Transfusion Medicine in collaboration with the Medicine Department, King George’s Medical University, Lucknow India. Results: In our study total of 60 cases and total of 150 TPE cycles were performed. Maximum mean age (36±4) was observed for cough and vomiting both and maximum mean BMI was observed followed for Infection at phlebotomy site (36.34±5.09). Maximum mean variation of hemoglobin was observed for vomiting (2.28±0.00), followed by internal bleeding. Maximum mean variation of activated partial thromboplastin time (aPTT) was observed for cough (22.05±0.34), followed by vomiting. Maximum mean variation of prothrombin time (PT) was observed for hypothermia (13.16±10.47), followed by internal bleeding. Maximum mean variation of S. creatinine was observed for abdominal discomfort (0.23±1.54), followed by vomiting. Maximum mean variation of systolic blood pressure (SBP) was observed for cough (7.00±5.20), followed by bipedal edema. Maximum mean variation of SpO2 was observed for death. Conclusions: Complication within 24 hours after the procedure was abdominal discomfort mainly in males with a correlation with body mass index (BMI). We observed significant positive association with complication versus APTT, PT, S. urea, S. creatinine, pulse, SBP, SpO2 and BMI. This emphasizes the decreasing trend of the complications with the increase in number of cycles.
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