Effect of splenectomy on red blood cell transfusion refractoriness in patients with hemophagocytic lymphohistiocytosis
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摘要: 目的 回顾性分析脾切除术对改善噬血细胞性淋巴组织细胞增多症(HLH)患者红细胞输注无效的效果。方法 选取2013年1月1日至2021年6月31日HLH患者16例，收集脾切除术前后输注红细胞的人数、次数以及每次输注红细胞的数量，查询输注红细胞前后血红蛋白(Hb)值；计算输注红细胞后Hb(g/L)值变化(△Hb)，以及判断输血疗效，计算红细胞输注无效次数。结果 脾切除术前9例患者28次共输注59 U红细胞，△Hb为7.89，红细胞输注无效次数为9次；脾切除术后5例患者10次共输注19 U红细胞，△Hb为12.82，红细胞输注无效次数为0次。行脾切除术后，输注红细胞数量减少、次数下降、疗效上升，红细胞输注无效次数下降。结论 脾切除术可显著降低红细胞输注数量和次数，显著提高红细胞输注疗效，特别对于降低红细胞输注无效有明显作用。
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关键词:
- 噬血细胞性淋巴组织细胞增多症 /
- 红细胞输注无效 /
- 脾切除术
Abstract: Objective To retrospectively analyze the effect of splenectomy on improving the red blood cell transfusion refractoriness in hemophagocytic lymphohistiocytosis.Methods A total of 16 patients with hemophagocytic lymphohistiocytosis between January 1, 2013 and June 31, 2021 were selected, and the number and frequency of red blood cell transfusions before and after splenectomy and the number of red blood cell transfusions were collected. Quantity, query the hemoglobin(Hb) value before and after the red blood cell transfusion; calculate the Hb(g/L) value change(△Hb) after the red blood cell transfusion, determine the effect of blood transfusion, and calculate the number of red blood cell transfusion refractoriness.Results Before splenectomy, 9 patients received a total of 59 U red blood cell transfusions for 28 times, △Hb was 7.89, and the number of red blood cell transfusion refractoriness was 9 times.After splenectomy, 5 patients received a total of 19 U red blood cell transfusions for 10 times, △Hb was 12.82, and the number of red blood cell transfusion refractoriness was 0. After splenectomy, the number of red blood cell transfusions decreased, the frequency decreased, the curative effect increased, and the number of red blood cell transfusion refractoriness decreased.Conclusion Splenectomy can significantly reduce the number and frequency of red blood cell transfusion, and can significantly improve the efficacy of red blood cell transfusion, especially for reducing the red blood cell transfusion refractoriness. -
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表 1 脾切除术前后输注红细胞疗效分析
项目 脾切除前 脾切除后 P 输注红细胞数量/U 2.00(0，5.75) 0(0，2.00) 0.017 输注红细胞次数 1.00(0，3.00) 0(0，1.00) 0.022 红细胞输注疗效(△Hb)/2 U 9.25(3.25，12.00) 14.50(10.25，18.25) 0.008 红细胞输注无效次数 9 0 0.043 
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