血液病患者输血前护理干预与输血不良事件风险研究  

Impact of Nursing Intervention before Blood Transfusion on the Risk of Adverse Transfusion Events in Patients with Hematologic Diseases

作　　者：夏琳[1] 陈明[1] XIA Lin;CHANG Ming(Genetic Diagnosis Center,and Department of Transfusion of Zhongnan Hospital of Wuhan Universi ty,Wuhan 430071)

机构地区：[1]湖北省武汉大学中南医院,430071

出　　处：《临床输血与检验》2018年第5期542-544,共3页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的对临床上需要输血治疗的血液系统疾病患者进行输血前护理干预,分析发生输血不良事件的风险,为血液系统疾病患者输血护理提供安全保障。方法选取本院血液科2015年1～12月2 112例需要输注血液制剂治疗的患者为研究对象,随机分为对照组1 056例和研究组1 056例,对研究组患者输血前进行心理咨询、心理护理和心理分析等干预,对对照组患者进行常规输血护理。比较两组患者输注各种血液成分发生输血不良事件的风险。结果两组发生输血不良事件的风险为5.82%(123/2 112),对照组发生输血不良事件的风险为7.39%(78/1 056),明显高于研究组的4.26%(45/1 056),差异有统计学意义(P<0.05);输注新鲜冰冻血浆、冷沉淀凝血因子两组患者间发生输血不良事件风险的差异无统计学意义(P>0.05),研究组略低于对照组;输注血小板、红细胞两组患者间差异有统计学意义(P<0.05);红细胞中洗涤红细胞输血风险明显低于悬浮红细胞(P<0.05);不同病种中,研究组和对照组发生输血不良事件风险比较,差异均有统计学意义(P<0.05),且多发性骨髓瘤患者发生风险较高(11.24%)。结论血液系统疾病患者在成分输血(特别是血小板和红细胞)治疗时进行输血前护理干预很有必要,同时输血治疗也应考虑患者的病种等进行输血前护理干预。Objective To explore the effects of the nursing intervention before blood transfusion on prevention of adverse transfusion events in patients with hematologic diseases. Methods A total of 1112 patients whohad received transfusion therapy in haematology department in 2015 were randomly divided into two groups,the control group（n =1 056） and experimental group（n =1 056）. The control group was administered with traditional nursing modelwhereas the experiment group was given psychological counseling,nursing,and psychological analysis in addition to the routine nursing. The incidence of adverse transfusion events between the two groups were compared indifferent blood products.Results A total of 123 patients with adverse transfusion events in the two groups,with a frequency of 5.82%. The incidence rate inthe control group was significantly higher than that of the experiment group（7.39% vs 4.26%,P〈0.05）. There was no difference between the two groups with frozen plasma transfusion（P〈0.05） and cryoprecipitatedantihemophilic factors transfusion（P〈0.05）. Adverse transfusion events of the experiment group with plateletand erythrocytetransfusions were obviously lower than those of the control group（P〈0.05）,especiallyof the patients with multiple myeloma.Conclusions Nursing intervention before blood transfusion is indispensable forpatients with hematologic diseases with blood component therapy,particularly with platelet orerythrocyte transfusion.

关 键 词：血液系统疾病 护理干预 输血不良事件 输血风险 

分 类 号：R552[医药卫生—血液循环系统疾病] R457.1[医药卫生—内科学]