血库前移系统在术中输血的应用探讨  

Application of blood bank antedisplacement system in intraoperative blood management

作　　者：程聪[1] 程华伟[2] 赵林[3] 吕翠[2] 刘术臻[1] 鞠强 CHENG Cong;CHENG Huawei;ZHAO Liny;LV Cui;LIU Shuzhen;JU Qiang(Department of Blood Transfusion;Department of Cardiovascular Surgery;Operating Room , the Affiliated Hospital of Qingdao University)

机构地区：[1]青岛大学附属医院输血科,山东青岛266003 [2]青岛大学附属医院心外科,山东青岛266003 [3]青岛大学附属医院手术室,山东青岛266003

出　　处：《中国输血杂志》2019年第6期592-595,共4页Chinese Journal of Blood Transfusion

摘　　要：目的构建血库前移系统,将血液管理从医院血库有效地延伸至手术室,探讨该系统在保障手术患者及时用血和手术安全的有效性。方法整合智慧输血信息管理系统和全流程血液冷链监管体系,通过电子配血系统联合物联网血液冷藏箱的使用,对手术患者输血管理实施血库前移;将患者申请的血液制品,提前放置手术室,患者术中用血随用随取。选取血库前移系统应用前后各50例(主要是心脏大血管和肝移植等大手术)病人用血数据进行比较,计数资料的统计分析用卡方检验,统计学分析使用SPSS13.0进行,评价该系统在术中输血管理中的作用。结果手术患者输血管理实施血库前移后,将医院血库的管理有效地延伸至手术室,分配和追踪血液产品的使用,实时记录血液制品的输注,将血液的管理延伸至床旁设备。患者术中用血从发起申请到输注,由传统管理模式的20min缩短到不足2 min;血库前移实施后,心脏大血管和肝移植等大手术患者术中输血后血色素超过110g/L比例明显降低,由血库前移系统实施前的26.0%降低至4.0%(χ2 =9.49,P<0.01),具有统计学意义;手术备血使用率由原来的84.0%下降至54.0%(χ2 =10.52,P<0.01),具有统计学意义。结论术中输血管理实施血库前移后,提供了手术患者血液管理解决方案创新模式,提高了血液管理效率和术中受血者的手术安全;节约了宝贵血液资源,提高了输血安全性,降低了患者医疗费用。Objective To construct the blood bank antedisplacement system and extend blood management from hospital blood bank to operation room, and to explore the effectiveness of the system in ensuring timely blood use and operation safety for patients during the intraoperative periods. Methods Integrating the intelligent blood transfusion information management system and the whole blood cold chain supervision system, the blood products ordered by the surgeon were placed in the operating room in advance with the electronic blood crossmatching system combined with the Internet of things blood reefer. The blood could be taken whenever it was needed during the intraoperative period. The data of blood transfusion were collected from 50 cases cardiovascular vessel and liver transplantation operation predominated before and after the application of the blood band antedisplacement system, respectively. The statistical analysis of the data was performed by Chi-square test. The software SPSS13.0 was used to perform statistical analysis to assess the role of this system during intraoperative period. Results The blood band antedisplacement could extend the management of the blood bank effectively to distribute and track the use of blood products and record the transfusion of blood in real time. The management was extended to bedside equipment. During the operation, the time from application to infusion was shorten from over 20 minutes(traditional management mode) to less than 2 minute(blood bank antedisplacement). After the application of this system, the proportion of hemoglobin more than 110 g/L including cardiac macrovascular and liver transplantation was significantly reduced(26.0% vs 4.0%,χ2 =9.49, P<0.01). The transfusion rate of surgical prepared blood was significantly reduced from 84.0% to 54.0%(χ2=10.52, P<0.01).Conclusion The application of blood bank antedisplacement system in intraoperative transfusion management can provide an innovative model of intraoperative blood management solutions, improve the efficiency of b

关 键 词：血库前移 管理效率 安全用血 手术安全 

分 类 号：R457.12[医药卫生—治疗学]