重症监护病房患者临床用血评价考核客观指标对比分析及临床用血特点  

Comparison and analysis of the objective indicators for evaluating clinical blood transfusion and the characteristics of using blood components in patients of intensive care unit

作　　者：张金荣[1,2,3] 黄俊[1,2,4] 谈春荣[1,2,3] 杨夏[1,2,5] 庄健美[1,2,3] 唐丽珍[1,2,3] 陈岩[1,2,3] 于文娟[1,2,3] 翟月萌 何欣[1,2,3] 

机构地区：[1]首都医科大学附属北京世纪坛医院 [2]首都医科大学肿瘤医学院 [3]北京大学第九临床医学院输血科,北京100038 [4]北京大学第九临床医学院病案统计科,北京100038 [5]北京大学第九临床医学院信息中心,北京100038

出　　处：《中国输血杂志》2015年第2期145-149,共5页Chinese Journal of Blood Transfusion

摘　　要：目的分析近4年重症监护病房(ICU)患者临床用血评价考核客观指标变化及用血特点,促进危重症患者合理用血管理;方法回顾统计2010-2013年我院ICU患者各血液成分使用情况和临床医疗基础数据和指标;使用"临床输血数据挖掘软件"对相关数据进行整合;对比分析临床用血评价考核客观指标及临床医疗质量效益指标。结果近4年我院ICU住院患者人数年均增长约30%,同期血液制品总输注率、红细胞输注率、血浆输注率、血小板输注率、ICU出院患者例均输血量、输血患者例均输血量等均呈现明显下降趋势;相同时期ICU住院患者总死亡率、平均住院日、总费用、院内感染率等均呈现不同程度下降;输血与未输血患者相关指标对比差异显著(P<0.01)。结论近4年ICU患者血液管理初见成效,严格临床输血指征对ICU患者进行临床用血综合管控,有利于ICU患者总体医疗质量改善。Objectives To analyze the objective indicators for evaluating clinical blood transfusion and the characteristics of using blood components for the patients in the Intensive Care Unit（ICU） and to improve appropriate blood use in critically ill patients.Methods A retrospective review for the usage of blood components and clinical basic data of the ICU patients from 2010 to 2013 has been done with the homegrown data mining software.The objective indicators for evaluating clinical blood transfusion and the characteristics of using blood components in patients of ICU were analyzed and compared.Results The numbers of patients were growing at over 30% in the ICU during past four years.At the same time,total incidence rate of blood transfusion,incidence rates of red cell transfusion,plasma transfusion,platelet transfusion,and average transfused units of red blood cell,plasma and platelet blood components per discharge patient and per transfused patient from the ICU exhibited an obvious downward trend.During the same period,total mortality,average length of stay,total cost,and incidence rate of nosocomial infection have shown a consistent decline.The indicators related with blood transfusion compared between transfused and non-transfused patients were significantly different（P0.01）.Conclusion The effects of the patient blood management have shown an apparent improvement during the past four years in our ICU.A transfusion trigger based on evidence-based medicine was implemented,and was beneficial for monitoring appropriate blood use in clinical transfusion and improving overall health quality of ICU patients.

关 键 词：临床输血 输血率 例均输血量 重症监护病房 

分 类 号：R457.1[医药卫生—治疗学]