中国输血杂志2025，Vol.38Issue(8)：1035-1042,8.DOI:10.13303/j.cjbt.issn.1004-549x.2025.08.006
自体富血小板血浆对A型主动脉夹层患者血液保护的有效性及预后影响
Effectiveness of autologous platelet-rich plasma for blood conservation and its prognostic impact in patients with type A aortic dissection
摘要
Abstract
Objective To investigate the effects of autologous platelet-rich plasma(aPRP)collected using a continuous blood cell separator on blood conservation and prognosis in patients with type A aortic dissection.Methods The clinical data of patients who underwent emergency aortic replacement for acute type A aortic dissection at our hospital from January 2020 to December 2023 were respectively analyzed.Patients were divided into two groups based on whether they received aPRP collection before surgery for subsequent reinfusion:the aPRP group(n=32)and the control group(n=35).The vol-ume of aPRP collected and the platelet concentration in the aPRP were recorded.The volumes of allogeneic blood and blood products transfused,and the associated costs during hospitalization were compared between two groups.Intraoperative blood loss,perioperative laboratory parameter changes,24-hour postoperative drainage volume,duration of ICU stay and mechani-cal ventilation,length of hospital stay,and mortality rate of the two groups were also compared.Results The platelet con-centration in aPRP was(491.5±85.4)×109/L,accounting for(24.1±9.6)%of the patient's total platelet count.The vol-ume of aPRP collected accounted for(23.0±6.3)%of the patient's total plasma volume.Compared with the control group,the aPRP group demonstrated significantly reduced transfusion volumes of allogeneic red blood cells,plasma,and platelets(P<0.05),along with significantly lower blood-related costs during hospitalization(P<0.05).Postoperative co-agulation parameters(APTT,PT,INR,and TEG)were significantly improved(P<0.05),and platelet counts were markedly increased(P<0.05)in aPRP group as compared with the control group.No statistically significant differences were observed in postoperative use of prothrombin complex concentrate and fibrinogen between the two groups.Similarly,there were no significant differences in postoperative 24-hour drainage volume,24-hour extubation rate,ICU length of stay,duration of mechanical ventilation,or total hospital length of stay.The incidence of complications and mortality did not dif-fer significantly between the two groups.Conclusion The administration of aPRP significantly reduces the requirement for perioperative allogeneic blood transfusion in patients undergoing surgery for type A aortic dissection.Furthermore,it en-hances coagulation function and reduces associated transfusion costs,thereby establishing itself as an effective and safe strat-egy for blood conservation.关键词
自体富血小板血浆/A型主动脉夹层/血液保护/血栓弹力图/凝血功能/预后影响Key words
autologous platelet-rich plasma(aPRP)/type A aortic dissection/blood conservation/thromboelastogra-phy/coagulation function分类
医药卫生引用本文复制引用
郑倩,陈守梅,谢明,智深深,刘坤,江艇..自体富血小板血浆对A型主动脉夹层患者血液保护的有效性及预后影响[J].中国输血杂志,2025,38(8):1035-1042,8.基金项目
重庆市渝中区基础研究与前沿探索项目(20200140) （20200140）
