关于冰冻血小板的质量
"冰冻前及融化后使用前22±2℃平衡4h"肯定是没有必要的。
"37℃静止水浴融化"要改为38℃循环水浴融化。
将冷却速度控制在－1℃/min（不是2±1℃/min）左右尤其是-15℃～-40℃之间是关键；
运输不能用冰盒，否则冰冻保存失败（常见）；
冷冻时冰箱温度低于-60℃（放入时开盖时间过长或冰箱制冷能力不够），冰冻保存失败（常见）；
冷冻是叠放或厚盒装，冰冻保存失败（常见）；
冰箱停电超过2小时，冰冻保存失败（常见）；
根据我研究的结果，反映冰冻血小板质量的两个最佳指标是磷脂酰丝氨酸阳性率（反映细胞膜不对称性的改变）和SPAT（薄片血小板聚集时间，反映血小板的释放和聚集功能）。
顺便指出另外两处
（有报道冰冻血小板的止血效果只有新鲜血小板的55％）。其中"止血效果"肯定不对，应该是提高血小板计数的能力约为新鲜血小板的50％。止血效果应该是优于液体保存血小板，文献及摘要如下
TI: Comparison of the effects of transfusions of cryopreserved and liquid-preserved platelets on hemostasis and blood loss after cardiopulmonary bypass.
AU: Khuri,-S-F; Healey,-N; MacGregor,-H; Barnard,-M-R; Szymanski,-I-O; Birjiniuk,-V; Michelson,-A-D; Gagnon,-D-R; Valeri,-C-R
SO: J-Thorac-Cardiovasc-Surg. 1999 Jan; 117(1): 172-83; discussion 183-4
IS: 0022-5223
LA: English
AB: OBJECTIVE: The aim of the study was to compare the clinical effects and hemostatic efficiency of transfusions of platelets preserved in the frozen state for as long as 2 years with transfusions of platelets preserved in the conventional manner for as long as 5 days in patients undergoing cardiopulmonary bypass. METHODS: Seventy-three patients were prospectively randomly assigned to receive transfusions of cryopreserved or liquid-preserved platelets. Nonsurgical blood loss was measured during and after the operation. Bleeding time, hematologic variables, and the bleeding time site shed blood were assayed before cardiopulmonary bypass and at 30 minutes and 2, 4, and 24 hours after transfusion. In vitro platelet function tests were conducted on platelets obtained from healthy volunteers. RESULTS: No adverse sequelae of the transfusions were observed. Blood loss and the need for postoperative blood product transfusions were lower in the group receiving cryopreserved platelets. Lower posttransfusion platelet increments and a tendency toward decreased platelet survival were observed in patients receiving cryopreserved platelets. Hematocrit and plasma fibrinogen were significantly higher in this group, and the duration of intubation was shorter. In vitro, cryopreserved platelets demonstrated less aggregation, lower pH, and decreased response to hypotonic stress but generated more procoagulant activity and thromboxane. CONCLUSIONS: (1) Cryopreserved platelet transfusions are superior to liquid-preserved platelets in reducing blood loss and the need for blood product transfusions after cardiopulmonary bypass. (2) The reduction in blood loss in the patients receiving cryopreserved platelet transfusions after cardiopulmonary bypass probably reflects improved in vivo hemostatic function of cryopreserved platelets. (3) Some in vitro measures of platelet quality (aggregation, pH, hypotonic stress) may not reflect in vivo quality of platelet transfusions after cardiopulmonary bypass, whereas other in vitro measures (platelet procoagulant activity and thromboxane) do.
也就是
