四家不同级别医院全髋关节置换术围术期用血分析  

Analysis on perioperative blood usage during total hip arthroplasty in four different graded hospitals

作　　者：姚立[1] 强文[1] 陈国安[1] 张浩[1] 潘小军[1] 

机构地区：[1]武汉血液中心,湖北武汉430030

出　　处：《中国输血杂志》2016年第2期184-186,共3页Chinese Journal of Blood Transfusion

基　　金：湖北省卫生厅科研基金项目(CGX2012-8)

摘　　要：目的了解全髋关节置换手术在不同等级医院临床用血量,为临床用血提供数据参考,促进血液中心供血调控和加强临床用血管理。方法回顾性比较分析武汉4家不同等级医院512例全髋置换手术围手术期临床用血的红细胞和血浆输注量及其术中、术后输注率,分析其临床用血特点和科学性。结果红细胞输注量上,省级综合性三甲B医院最少;血浆输注量上,市级骨科专科三甲C医院最少,市级一般三甲D医院最多;对于术中红细胞输注率,部属综合性三甲A医院和省级综合性三甲B医院较低;术后红细胞输注率,C医院最低,D医院最高;术中血浆输注率,C医院最低,D医院最高;而术后血浆输注率,A医院和C医院较低。结论临床用血量与医院级别有一定的关联,骨科专科医院在全髋关节置换手术围手术期临床用血控制较好,血浆输注量、输注率及术后红细胞输注率均是四种级别医院中最少和最低的。Objective To analyze the actual blood usage during total hip arthroplasty operation in four different graded hospitals, to provide useful data reference for rational clinical use of blood, to promote regulation of clinical use of blood in blood center and to strengthen the management of clinical blood usage. Methods A retrospective comparative analysis on 512 cases of perioperative use of blood components （ including infusion of red blood cells, the quantity of plasma infusion, the rate of intraoperative and postoperative infusion） during total hip arthroplasty operation in four different graded hospitals in Wuhan was conducted. The feasibility and rationality of clinical blood usage was analyzed. Results On RBC infusion volume, A level three provincial general hospital （B） had the lowest quantity. On the plasma infusion volume, orthopedics specialized hospital （C） had the lowest quantity while district hospital （D） had the highest quantity. On intraoperative RBC infusion rate, hospital （A） and hospital （B） had lower rates. Regarding the postoperative RBC infusion rate, hospital （C） scored the lowest, while hospital （D） scored the highest. On intraoperative plasma infusion rate, hospital （C） again scored the lowest, while hospital （D） scored the highest. On postoperative plasma transfusion rate, hospital （A） and hospital （C） had lower rates. Conclusion The clinical blood usage is related to the grade level of hospitals. Orthopedics specialized hos- pital carried on a well-controlled blood usage in total hip arthroplasty operation, with the lowest usage of plasma infusion vol- ume and transfusion rate and postoperative red blood cell transfusion rate among four different grade hospitals.

关 键 词：全髋关节置换术 围术期临床用血 血液管理 

分 类 号：R457.1[医药卫生—治疗学] R681.6[医药卫生—临床医学]