四川省40家综合医院临床用血情况调查与用血评估模式的初步探讨  

Research on clinical blood transfusion and preliminary discussion of evaluation model of clinical blood use in forty general hospitals in Sichuan province

作　　者：孔玉洁[1] 尹湧华[1] 田雪[1] 洪树青[2] 王向明[1] 田力 宋宁[1] 刘忠[1] KONG Yujie YIN Yonghua TIAN Xue HONG Shuqing WANG Xiangming TIAN Li SONG NingI LIU Zhong(Institute of Blood Transfusion, Chinese Academy of Medical Sciences ＆ Peking Union Medical College, Chengdu 610052, China School of Public Health, Anhui Medical University.)

机构地区：[1]中国医学科学院北京协和医学院输血研究所,四川成都610052 [2]安徽医科大学公共卫生学院

出　　处：《中国输血杂志》2017年第5期513-516,共4页Chinese Journal of Blood Transfusion

摘　　要：目的了解四川省综合医院的临床用血情况,对医院临床用血评估模式进行初步探讨。方法 1)设计《临床用血淍查表》,对四川省40家综合医院展开临床用血专项调研,统计40家医院临床成分血(红细胞、血浆、血小板和冷沉淀)用量在主要用血科室之间的分布情况;2)将成分血用量与医院年门诊人次、床位数、年住院人次和年手术台次做相关性分析;3)以单位年门诊人次用量、单位年住院人次用量、单位床位数用量、单位年手术台次用量为指标,分析红细胞用量,探索临床用血的评估机制。结果 1)红细胞和血小板用量最多的科室为内科,三级医院分别占总用量的40.60%和71.15%,二级医院分别占36.62%和51.04%;血浆主要用于内科和外科,三级医院分别占37.11%和34.90%,二级医院分别占27.76%和31.00%;2)三级医院的红细胞用量与年门诊人次、年住院人次、年手术台次及床位数的相关系数(r)分别为0.792、0.818、0.838和0.728,二级医院分别为0.242、0.780、0.793和0.693;3)三级医院以单位年手术台次红细胞用量为评估指标时,有1家医院偏离>x珋+2s;二级医院以单位年门诊人次、单位年住院人次、单位年手术台次和单位床位数红细胞用量为评估指标时,各有1家医院偏离>x珋+2s。结论三级医院成分血应用较二级医院规范,红细胞是应用管理最好的血液成分。临床用血评估在了解医院用血情况的基础上,对同级医院进行用血量的对比分析,不仅可以在宏观上控制临床用血,也可为临床用血考评机制的建立提供有效的借鉴。Abstract： Objective To provide an effective basis for the formulation of long-term dynamic index evaluation of clinical blood transfusion, by analysis of blood use in 40 general hospitals in Sichuan province and discussion on an assessment model of preliminary clinical blood usage. Methods 1） The distribution of blood component transfusion including red blood ceils （RBCs）, plasma, platelet and cryoprecipitate were calculated among departments of main blood use in 40 hospitals. 2） A correlation analysis was made between blood component use and annual outpatient numbers, inpatient numbers, operation numbers and bed numbers, respectively. 3 ） The average blood usage amount of outpatient, inpatient, surgery and bed num- bers was used as the index to analyze red blood cells transfusion and to explore the evaluation model of clinical blood use. Re- suits 1） RBCs and platelet are mainly used in the department of medicine. The proportion was 40. 60% and 71.15% in third-tier hospitals and 36. 62% and 51.04% in second-tier hospitals. The primary usage of plasma is in the department of medicine and surgery, the percentage was 37. 11% and 34. 90% in third-tier hospitals and 27. 76% and 31.00% in second- tier hospitals. 2） The amount of RBCs in third-tier hospitals was positively correlated with the outpatient, inpatient, surgery and bed numbers and the correlation index was 0. 792, 0. 818, 0. 838 and 0. 728. The correlation coefficient in second-tier hospitals was 0. 242, 0. 780, 0. 793 and 0. 693, separately.3） When evaluating by the average transfusion of red blood cells per surgery in third-tier hospitals and the mean usage of red blood cells per outpatient, per inpatient, per surgery, or per bed in second-tier hospitals, five hospitals were two times standard deviation more than the average. Conclusion The use of blood component in third-tier hospitals is more standard than in second-tier hospitals. The use of RBCs is more than the other blood component. This study has analyzed the blood usage between t

关 键 词：临床用血 成分血用量 综合医院 用血评估 三级医院 二级医院 

分 类 号：R457.1[医药卫生—治疗学]