慢性肾衰竭血液输注的护理信息化管理和回顾性研究  

Nursing information management and retrospective study of blood transfusion in chronic renal failure

作　　者：朱萌华[1] 李凯强[2] 薛雅丹 陈惠敏 蒋璐茜[2] 裘丹英[3] 陈秉宇[2] 过湘钗[3] ZHU Menghua;LI Kaiqiang;XUE Yadan;CHEN Huimin;JIANG Luqian;QIU Danying;CHEN Bingyu;GUO Xiangchai(Department of Nephrology,the Affiliated People's Hospital of Hangzhou Medical College,Zhejiang People's Hospital,Hangzhou 310014,China;Department of Blood Transfusion,the Affiliated People's Hospital of Hangzhou Medical College,Zhejiang People's Hospital,Hangzhou 310014,China;Department of Nursing,the Affiliated People's Hospital of Hangzhou Medical College,Zhejiang People's Hospital,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院杭州医学院附属人民医院肾脏病科,浙江杭州310014 [2]浙江省人民医院杭州医学院附属人民医院输血科,浙江杭州310014 [3]浙江省人民医院杭州医学院附属人民医院护理部,浙江杭州310014

出　　处：《中国现代医生》2019年第2期138-141,共4页China Modern Doctor

基　　金：浙江人口计划生育科研项目(2014KYA233);浙江省医药卫生科技计划项目(2015KYB021;2016KYB012;2016DTB001;2017KY005);国家教育部基金(2017A11036)

摘　　要：目的探讨红细胞和血浆输注在慢性肾衰竭治疗中的作用。方法利用护理输血信息管理系统规范输血流程,对我院2013年1月～2016年7月共378例需要红细胞和血浆输注的患者病例进行回顾性调查统计分析,比较输注前后血红蛋白、白蛋白、肌酐、血氧饱和度以及凝血功能的变化。结果 378例患者中,输注红细胞悬液234例;输注血浆患者144例;红细胞输注后血红蛋白水平升高,血氧饱和度上升,肌酐下降,差异有统计学意义(P均<0.05);血浆输注后白蛋白水平显著上升,肌酐显著下降(P均<0.05)。红细胞输注前81.2%的患者血红蛋白低于60 g/L,属于合理用血范围,在输注后血红蛋白水平则明显升高(P<0.001);对血红蛋白水平高于60 g/L的患者输注红细胞后,血红蛋白水平虽有升高,但幅度较小(P<0.05),两组比较差异显著(P<0.01)。慢性肾衰竭合并肝损伤患者在血浆输注后凝血功能明显改善(P<0.05),但单纯肾衰竭患者在血浆输注后凝血功能却无明显差异。结论红细胞输注能显著改善肾性贫血症状,血浆输注可改善伴肝损伤患者的凝血功能,慢性肾衰竭病情复杂不一,应严格按个人贫血程度和凝血状况实现合理用血。Objective To investigate the role of red blood cell and plasma infusion in the treatment of chronic renal failure.Methods The nursing blood transfusion information management system was used to regulate the blood transfusion process.A retrospective survey was conducted on 378 patients requiring red blood cell and plasma infusion from January 2013 to July 2016 in our hospital.The changes of hemoglobin,albumin,creatinine,blood oxygen saturation and coagulation function were compared before and after infusion.Results Of the 378 patients,there were 234 cases of red blood cell suspension transfusion and 144 cases of plasma-transfusion.After red blood cell transfusion,hemoglobin levels and blood oxygen saturation increased,and creatinine decreased.The difference was statistically significant(P all<0.05).Albumin levels increased significantly after plasma infusion,and creatinine decreased significantly(P all<0.05).81.2%of patients with red blood cell transfusion had hemoglobin below 60 g/L,which was a reasonable blood use range,and hemoglobin level was significantly increased after transfusion(P<0.001).For patients with hemoglobin higher than 60 g/L,after the transfusion of red blood cells,the hemoglobin level increased,but the amplitude was small(P<0.05).The statistical difference between the two groups was significant(P<0.01).Coagulation function was significantly improved in patients with chronic renal failure and liver injury after plasma transfusion(P<0.05),but there was no significant difference in coagulation function after plasma infusion in patients with renal failure alone.Conclusion Red blood cell transfusion can significantly improve the symptoms of renal anemia.Plasma infusion can improve the coagulation function of patients with liver injury.The condition of chronic renal failure is complex.The rational use of blood should be achieved according to the degree of anemia and coagulation.

关 键 词：慢性肾衰竭 红细胞输注 血浆输注 回顾性分析 

分 类 号：R473.6[医药卫生—护理学]