医疗机构临床用血计划质量管理权重要素探析及应用研究  

Research and application on weight factors of quality management of clinical usage plan of blood in medical institutions

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

机构地区：[1]南昌大学第一附属医院,江西南昌330006

出　　处：《中国输血杂志》2015年第8期949-952,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨影响医疗机构临床用血量的质量管理权重要素,为临床用血计划制订、考核评价实施提供科学依据。方法通过临床输血管理与评价信息系统采集2010-2014年医院临床用血数据,分析临床用血量、出院患者人次、出院患者增长率、输血出院患者人次、异体输血患者人次、自体输血患者人次、手术台次、输血手术台次、出院患者增长率、出院患者输血率、自体输血率、出院患者均异体用血量、成分构成比等临床用血质量指标变化趋势及其相关性,以探讨在临床用血计划制订、考核评价实施中的应用价值。结果 1)异体输血患者人次、患者输血率、异体输血率、均红细胞(RBC)用量、均异体RBC用量均随患者自体输血增长而呈下降趋势,临床用血量与医疗工作量呈非平行增长关系;2)临床用血量、自体输血量与出院患者人次、自体输血患者人次、手术台次、自体输血率、输血出院患者均RBC量间呈正相关,而与出院患者输血率、出院患者异体输血率、出院患者均RBC量、出院患者均异体RBC量间呈负相关(P<0.05);异体成分血用量与异体输血患者人次呈负相关,与输血出院患者均RBC量呈正相关(P<0.05);3)血液制剂A、B、O、AB血型构成比分别为32.61%、24.61%、34.87%、7.91%,红细胞、血浆、血小板、冷沉淀品种构成比分别为29.88%、28.19%、33.73%、8.20%;血液制剂不同血型、不同品种和同一血型品种构成比2010-2014各年度及均值间差异均不具统计学意义(P>0.05)。结论临床用血质量管理持续改进对临床用血量权重影响显著,患者输血率、异体输血率和自体输血率、均异体红细胞用量和成分构成比是医疗机构临床用血计划质量管理权重要素,应纳入临床用血计划实施的考核评价指标。Objective To explore the weight factors of quality management of influencing clinical usage amount of blood in medical institutions, and to provide an scientific basis for the formulation and implementation and evaluation of clinical usage plan of blood. Methods Using the clinieal transfusion management and evaluation system, data on clinical blood use of our hospital from 2010 to 2014 were collected. The correlation of quality index of clinical transfusion with the amount of blood for clinieal usage, the number and growth rate of disqharged patients, the number of transfusion patients and allogeneie transfusion patients and autologous transfusion patients, the number of surgery and transfusion surgery, the blood transfusion and autologous blood transfusion rate, and the average allogeneic blood usage amount used by discharged patients and the constituent ratio of blood component were analyzed. Their changing trend were explored. Their application value of formulation and implementation and evaluation of clinical usage plan of blood were evaluated. Results A downward trend was found in the number of aUogeneic transfusion patients, blood transfusion and allogeneic blood transfusion rate, average red blood ceils （RBC） and allogeneic RBC usage amount with the growth of autologous blood transfusion in discharged patients. It is not parallel between the growth of clinical usage amount of blood and medical workload. The amount of blood for clinical usage and autologous blood transfusion were positively correlated to the number of discharged patients and autologous transfusion patients and surgery, the autologous blood transfusion rate, the average allogeneic blood usage amount of discharged patients, and negatively correlated to the rate of blood transfusion and allogeneic blood transfusion, average RBC and allogeneic RBC usage amount of discharged patients （P 〈 0. 05 ）, respectively. Clinical usage amount of allogeneic blood components was negatively correlated to the number of allogeneic transfusion patient

关 键 词：临床用血计划 质量管理 权重要素 临床用血量 血液制剂 

分 类 号：R457.1[医药卫生—治疗学]