输血申请单与取血处方在临床用血中的协同管理  

The collaborative management of blood transfusion application form and transfusion prescription in clinical patient blood management

作　　者：彭道波[1] 赖福才[1] 邹健[2] 赵晖[1] 孔文兵[1] 施志敏[1] 苏明[1] 

机构地区：[1]南方医科大学南方医院输血科,广东广州510515 [2]南方医科大学南方医院信息科,广东广州510515

出　　处：《中国输血杂志》2016年第3期287-293,共7页Chinese Journal of Blood Transfusion

摘　　要：目的探讨输血申请单与取血处方在临床用血管理中的协同作用。方法分别从医院信息系统(HIS)、实验室信息系统(LIS)、输血信息系统(TIS)收集南方医院2013年9月-2014年12月的所有输血资料,包括患者信息、申请信息、处方信息、发血信息,统计分析4种血液成分和储存式自体全血在有关输注适应证和输血目的中的使用情况,以及输血前评估1(患者重要器官功能评估分级与高血压分级等5项)、输血前评估2(患者是否自体输血、出血、贫血、严重感染、使用相关药物等6项)、输血前评估3(患者当前生命体征、失血量及其他症状与特别要求等8项)内容填写情况。结果 8 487(人)次输血病例共已发血的申请单43 105份、处方分45 617份,有效发放血液49071次共82 837袋。按取血处方的输血适证分组统计,其中输注红细胞以急性失血、慢性贫血及围术期为主要输注适应证,三者输血量占到总输血量87.98%(43 949.0 U/49 954.5 U),这3类患者输注红细胞前Hb有明显差异(P<0.01);输注血浆类以急性失血、凝血功能障碍及围术期为主要输注适应证,三者输血量占到总输血量66.91%(34085.5 U/50 941.5 U);输注机采血小板以预防性输注、出血/DIC及急性失血为主要输注适应证,三者输血量占到总输血量77.15%(8 556.0个治疗剂量/11 090.5个治疗剂量),这3类患者输注血小板前Plt,除出血/DIC和预防性输注无明显差异(P>0.05)外,其余组间有明显差异(P<0.01);输注冷沉淀以急性失血、凝血功能障碍及出血/DIC为主要输注适应证,三者输血量占到总输血量75.06%(4 788.0 U/6 378.5 U);输注储存式自体全血以围术期、预防性输注、急性失血为输注适应证,总输注量216.5 U。按输血申请单的4个输血目的(慢性贫血、急性失血、围术期、其他治疗)分组统计,其中输注红细胞前患者Hb值除慢性贫血和急性失血无明显差异(P>0.05)外,其余组间有明显差异(Objective To investigate the collaborative effect of blood transfusion application form and transfusion preseripfion in clinical patient blood transfusion management.Methods All blood transfusion data of Nanfang Hospital from September 2013 to December 2014 were collected from the Hospital Information System （HIS）, the Laboratory Information System （LIS）, and the Transfusion Information System （TIS）, including patient information, prescnption information and blood dispensation information. The usage of four blood components and preoperative autologous whole blood were analyzed statistically in terms of indication and purpose of transfu- sion. The completion of Pre-Transfusion Evaluation 1 （5 entries including： the evaluation of essential organ function, hyper- tension classification, etc）, Pre-Transfusion Evaluation 2 （6 entries including： history of autologous blood transfusion, hem- orrhage, anemia, severe infection, and related medication, etc）, and Pre-Transfusion Evaluation 3 （8 entries including： vi- tal signs, amount of blood loss, other symptoms, and special requests, etc, at the time before transfusion） were also as- sessed. Results A total of 8 487 （patients＇） blood transfusion cases, 43 105 application forms with dispensed blood, 45 617 prescriptions, 49 071 valid blood dispensation with a total of 82,837 bags of blood were analyzed. Statistics were ana- lyzed by groups, which were divided according to the indications of transfusion written on the transfusion prescriptions ： acute hemorrhage, chronic anemia, and perioperative period constituted the major indications for red blood cell transfusion, con- tributing 87.98% （43 949.0 U/49 954. 5 U） of the total transfusion amount. The difference of patient hemoglobin levels be- fore transfusion between either two of these three groups were all statistically significant （P 〈0. 01 ）. Acute hemorrhage, co- aguIation disorders, and perioperative period constituted major indications for plasma transfusion, contribu

关 键 词：临床用血 输血申请单 输血处方 输血管理 协同作用 电子化 信息化 

分 类 号：R457.1[医药卫生—治疗学]