手术患者红细胞输注计划与实施符合性评价研究与应用  

Research and application of conformity assessment on red blood cell transfusion in surgical patients in planning and implementation

作　　者：孙福廷[1] 冀宝军[1] 王立萍[1] SUN Futing JI Baojun WANG Liping.(Weifang Peoples Hospital, Weifang 261041, China)

机构地区：[1]潍坊市人民医院输血科,山东潍坊261041

出　　处：《中国输血杂志》2017年第1期38-40,共3页Chinese Journal of Blood Transfusion

摘　　要：目的分析手术患者术前用血计划与术中实际输血量符合率,为术前制订科学合理有效的用血计划提供理论依据。方法通过对2011年1月1日-2013年12月30日本院手术患者围手术期输血情况进行回顾性调查,统计3年间用血量比较大的手术用血情况,以全髋关节置换术为例统计计划量与实际用血量的差异,采用t检验方法分析评价其符合性。结果 1)手术输血患者占手术患者比例逐年降低,手术患者人均红细胞输注量逐年降低。2)用血比例较大的几类手术3年间手术中红细胞输注量差异不具统计学意义(P>0.05)。3)超计划输血占总手术用血人次的16.3%,超计划用血患者计划血量与实际用血量差异具统计学意义(P<0.05)。4)股骨头缺血性坏死、股骨颈骨折、其他髋关节病变所致全髋关节置换术患者红细胞术前计划量与术中实际用血量分别为:2.97±1.01 U,4.77±2.33 U;3.26±0.99 U,5.42±3.91 U;3.16±1.07 U,6.08±4.80 U,计划量与实际输注量差异均具统计学意义(P<0.05)。结论术前制订有效的用血计划非常必要,对保障输血安全、手术安全意义重大,应尽量避免超计划用血,杜绝无计划用血,在综合评估患者个体情况下,术前红细胞用血计划可参考该类手术最近3年平均用血量。Objective To analyze the coincidence rate of surgical patients＇ preoperative planned blood use and actual amount of intraoperative blood transfusion,and to provide scientific and reasonable theoretical basis for implementation of preoperative blood use plans. Methods Retrospective investigation was carried out on perioperative blood transfusion in surgical patients in our hospital between January 1,2011 and December 30,2013. The differences of amounts of blood between preoperative planning and intraoperative actual transfusion in patients with total hip replacement were analyzed by t-test using SPSS17. 0. Results 1）. The proportion of surgical blood transfusion in surgical patients showed a decreasing trend,so did the average volume of red blood cell transfusions in surgery patients. 2）. There were no significant differences in perioperative blood transfusions between several blood-consuming-operation in three years（ P〉0. 05）. 3）. Excess blood use accounted for 16. 3% of the total number of surgery. There were significant differences between planned and actual blood transfusion in patients with over use of blood transfusion（ P〈0. 05）. 4）. There were significant differences between planned and intraoperative red blood cell transfusion in patients with total hip arthroplasty（ 2. 97 ± 1. 01,4. 77 ± 2. 33;3. 26 ± 0. 99,5. 42 ±3. 91;3. 16 ± 1. 07,6. 08 ± 4. 80）,（ P〈0. 05）. Conclusion Preoperative planning and effective use of safety are of great significance to ensure the safety of blood transfusion and surgery,avoid excessive use of blood and eliminate unplanned use.Under the comprehensive evaluation of individual patients,preoperative blood use plan may refer to the average volume used in surgery in the last three years.

关 键 词：用血计划 实际用血量 手术患者 符合性 评价 

分 类 号：R457.1[医药卫生—治疗学]