外科患者术中用血质量管理成效分析  

Analysis on the effectiveness of quality management on intraoperative blood transfusion for surgical patients

作　　者：乐爱平[1] 李建林[1] 陈世彪[1] 杨丽云[1] 杨鹃[1] 吴承高[1] 李松[1] 

机构地区：[1]南昌大学第一附属医院输血科,江西南昌330006

出　　处：《中国输血杂志》2014年第12期1324-1327,共4页Chinese Journal of Blood Transfusion

摘　　要：目的分析外科患者术中用血质量管理持续改进的成效。方法针对医院围手术期血液管理存在的问题持续改进,并利用信息化手段统计医院2010～2013年外科患者手术台次、输血手术台次、异体及自体输血手术台次、术中异体用血量和台均异体用血量、手术等级等指标,以分析术中用血质量管理指标与用血趋势。结果 1）2010～2013年外科患者手术台次呈递增趋势,而异体输血手术台次率、手术异体红细胞用量、台均异体红细胞和血浆用量、异体血浆与红细胞用量比均呈负增长趋势。2）2013年外科患者手术台次,较2011年增长了30.41%,而异体输血手术台次与比率、台均异体红细胞和血浆用量,及血浆与红细胞用量比分别降低了5.56%、1.81%、28.57%、26.32%、51.90%;术中自体红细胞输注率、异体红细胞与血浆输注合理率均呈递增趋势,2013年达到预期质量管理目标,分别为80.0%、96.50%、91.82%。3）手术等级与术中异体输血率间有相关性（r=0.14,P〈0.001）,手术等级越高,术中异体输血率增高（P〈0.001）;不同年份间术中异体输血率存在差异,二级以上手术术中异体输血率呈下降趋势（P〈0.001）。结论医院临床用血质量管理体系和术中用血质量管理持续改进成效显著,有效提升了科学、有效、安全用血水平,保护了血液资源。Objective To analyze the continuous improvement in the quality management of intraoperative blood trans- fusion for surgical patients. Methods Blood management problems existing in the perioperative period were first identified for strategies on continuous improvement. A statistical analysis was then conducted from 2010 to 2013 among surgical inpa- tients using information technology on the following indicators ： numbers of operation, numbers of transfusion, numbers of al- logeneic and autologous transfusion during surgery, the total and average amount of intraoperative allogeneic transfusion .. and surgical grade. Results From 2010 to 2013, the manbers of surgery have increased year by year, while the ratio cf the numbers of allogeneic blood transfusion during surgery to the average amount of intraoperative allogeneic red blood cell,; and plasma and the total usage of plasma and erythrocyte during the operations showed a negative trend. In 2013, the numbers of operations increased by 30. 41% than in 2011, but the numbers of operation with allogeneic blood transfusion declined by 5.56%, with its ratio to the average dosage of allogeneic red blood cells and plasma, and the total usage of plasma and eryth- rocyte reduced by 1.81% , 28. 57% , 26. 32% and 51.90% , respectively. The rate of autologous transfusion and the use of allogeneie blood and plasma were on the rise, achieving the desired target on blood quality management by 80. 0%, 96. 50%, 91.82%, respectively in 2013. There was a positive correlation between surgical grade and the rate of intraopera- tire allogeneic blood transfusion （ r = 0. 14, P 〈 0. 001 ） ： the higher level the operation, the higher the rate of intraoperatlve allogeneic transfusion （P 〈 0. 001 ）. The intraoperative allogeneie blood transfusion rate was different depending on the year conducted. The rate of intraoperative allogeneic blood transfusion declined in surgeries with second grading and above （ P 〈 0. 001 ）. Conclusion Continuous improvement of quality manag

关 键 词：临床用血 术中用血 质量管理 持续改进 成效 

分 类 号：R457.1[医药卫生—治疗学] R619[医药卫生—临床医学]