浙江省三甲医院围术期临床用血情况调查  

Investigation of the status of perioperafive blood transfusion in grade m-A general hospitals in Zhejiang province

作　　者：姚媛媛[1] 王海莺[1] 祝胜美[2] 黄长顺 李军[4] 楼静芝[5] 彭丛斌[6] 杜光生[7] 汪卫星[8] 孙建良 严敏[1] 

机构地区：[1]浙江大学医学院附属第二医院麻醉科,杭州310009 [2]浙江大学医学院附属第一医院 [3]宁波李惠利医院 [4]温州医学院附属第二医院 [5]绍兴市人民医院 [6]台州医院 [7]金华市中心医院 [8]湖州市中心医院 [9]嘉兴市第一人民医院

出　　处：《中华医学杂志》2010年第13期894-897,共4页National Medical Journal of China

基　　金：基金项目：卫生部科研基金省部共建基金（WKJ2008-2-021）

摘　　要：目的了解浙江省三甲医院围术期临床用血状况，为提高临床安全合理用血水平提供数据。方法依据《临床输血技术规范》编制调研登记表。调查浙江省9家综合性三甲医院2007年围术期输血患者的病例，分析用血指征的符合情况，统计术中和术后72h不同类型手术患者各血液成分的输注量和各血液成分使用的不合理率，对数据分别进行协方差分析和x2检验。结果19102次输血中，成分输血率达到99．3％，但是，有8251次红细胞输注和176次全血输注属于无指标输血，即44．1％的围术期用血是麻醉医生或者手术医生仅根据临床经验而实施的行为，其中包括了603例输血患者术后72h内仍没有复查Het或者血红蛋白水平。对于有完整输血指标检测记录的患者进行合理与否的判断，红细胞和全血输注的不合理率均为39．2％，主要原因是输注指征过宽，血小板输注不合理率为43．7％，主要是未达到输血指征时输注或者输注血小板量不足1个治疗量。结论尽管浙江省三甲医院围术期的成分输血开展良好，但仍然存在较严重的不合理输血现象，急需引起各家医疗机构重视，大力普及临床合理用血知识和提高安全用血意识。Objective To investigate the situation of perioperative blood transfusion in Grade Ⅲ-A hospitals in Zhejiang province, in order to provide statistics for improving appropriateness of blood transfusion. Method The questionnaire was conducted in 9 Grade Ⅲ-A hospitals in Zhejiang province according to ＂The Technical Criterion of Clinical Blood Transfusion＂. The data including total quantity , whole blood and component blood transfusion in 2007 were analyzed. Results Among 19 102 cases, the percentage of component blood transfusion was 99.3% ,but 44. 1% transfusion is conducted just according to doctors＇experience without any medical indication , including 603 patients not reexamining the level of Hct or Hb in 72 h after operation. For the patients with complete transfusion record, the irrational rate of whole blood, RBCand platelet transfusion were 39. 2%, 39. 2%, 43.7%, the mainly reason was the relax demand on the transfusion indication. Conclusions Although GradeⅢ-A hospitals in Zhejiang did fairly well in perioperative blood component transfusion, there are still some seriously unreasonable phenomenons . Every medical organization should pay more attention to improve the quality of clinical blood transfusion.

关 键 词：成分输血 输血指征 合理用血 

分 类 号：R457.1[医药卫生—治疗学]