一家三甲妇幼保健院PICU血浆输注的应用情况分析  

Analysis of the application of plasma transfusion in pediatric intensive care unit of a maternal and child health care hospital

作　　者：林鸿星[1] 毛晓丹[1] 翁斌[1] 陈陆飞[1] LIN Hongxing;MAO Xiaodan;WENG Bin;CHEN Lufei(Department of Transfusion,Fujian Provincial Maternityand Children Health Hospital,Fuzhou 350000,China)

机构地区：[1]福建省妇幼保健院输血科

出　　处：《中国输血杂志》2018年第10期1183-1186,共4页Chinese Journal of Blood Transfusion

摘　　要：目的了解本院儿科重症监护室(PICU)血浆输注的应用情况,总结血浆输注的经验,为血浆的合理应用提供参考。方法对本院2015—2017年PICU收治的共计2079例患儿的临床资料、血浆输注记录和实验室检查进行回顾性调查分析。结果1)近3年PICU成分输血中血浆的使用率最高,平均为38.64%,近2年使用率稳定(36.05%vs38.30%,P>0.05),较2015年均减低(43.01%)(P<0.05)。2)血浆输注人数与其收治人数相关性较小(r=0.369,P<0.05),血浆输注率为(10.96±4.08)%,危重/极危重组患儿的输注率高于非危重组(13.58%vs9.94%,P<0.05);人均输注量为(4.06±1.92)U,逐年增长(P<0.05)。3)血浆需求量在儿科系、全院总用量中占比分别为(67.75±15.86)%、(25.16±11.63)%。4)血浆用量及输注人数列一、3位的病因均为各种感染及血液系统疾病,列第2位的分别是脏器功能衰竭和外科疾病。单病种中肺炎是血浆输注的主要病因。5)12.39%(28/226)患儿血浆输注前未检测凝血指标,非危重组未检测率低于危重/极危重组(P<0.05);27.88%(63/226)患儿血浆输注前后均检测凝血指标;33.63%(76/226)患儿有输注后检测值。6)血浆输注组患儿住PICU平均天数长于未输注组(7.12dvs4.36d,P<0.05);在非危重组及危重/极危重组的同级比较中,血浆输注组天数长于未输注组(7.00dvs4.34d,7.44dvs4.42d,P<0.05)。7)血浆输注不良反应1例,发生率为0.44%(1/226),表现为过敏反应,停止输注后,经对症治疗缓解。结论部分临床医生对血浆输注的指征把握不严,非危重组患儿血浆输注的不合理应用较多,有待改善。还需完善输注前的检查和输注后的疗效评估,进一步保障用浆疗效和安全。Objective To evaluate the application of plasma transfusion in the pediatric intensive care unit( PICU) of our hospital and to obtain valuable experience of plasma transfusion. We hope to provide data reference for improved plasma transfusion.Methods The clinical data,plasma transfusion records and laboratory examinations of 2 079 PICU patients in our hospital from 2015 to 2017 were analyzed retrospectively. Results 1) In the past 3 years,the plasma transfusion accounted for the most of the transfusion cases at 38. 64% with little change in the past 2 years( P> 0. 05) but significantly less than 2015( P<0. 05). 2) The number of plasma transfusion cases showed little change with a transfusion rate of( 10. 96±4. 08) %. Patient with critical/extremely critical conditions present significantly higher plasma transfusion rates than the noncritical condition patients( P<0. 05). The volume of plasma transfused per patient increased annually. 3) The total plasma volume portions requested by the department of pediatrics and the entire hospital were stable,accounting for( 67. 75 ±15. 86) %、( 25. 16±11. 63) %.4) The top 3 causes for plasma transfusion are: various infections,organ failure and blood system diseases. Pneumonia was the main cause of plasma transfusion disease wise; The top 3 causes for the number of patients with transfusion are: various infections,surgical diseases and blood system diseases. 5) 12. 39%( 28/226) of the patients did not go through blood coagulation function tests before transfusion. The untested rate of the non-critical condition patients was lower than that of the critical/extremely critical condition patients( P<0. 05); Coagulation indicators were detected before and after plasma infusion in 27. 88%( 63/226) patients; 33. 63%( 76/226) patients were measured their blood coagulation indexes after the infusion.6) The treatment period in PICU of the plasma infusion group was longer than that of the noninfusion group( 7. 12 d vs 4. 36 d,P<0. 05) while the treatment period of the plasma infusio

关 键 词：PICU 血浆输注 

分 类 号：R457.14[医药卫生—治疗学]