某三甲医院产科临床用血特征及原因分析  

Retrospective analysis of the characteristics and causes of clinical blood transfusion in Obstetrics Department of a 3A hospital

作　　者：朱梅[1] 秦华 张小琦 巩超[1] 高小文[2] ZHU Mei;QIN Hua;ZHANG Xiaoqi;GONG Chao;GAO Xiaowen(Hanzhong Central Hospital,Hanzhong 723000,China)

机构地区：[1]汉中市中心医院妇产科,陕西汉中723000 [2]汉中市中心医院输血科,陕西汉中723000

出　　处：《中国输血杂志》2019年第12期1239-1242,共4页Chinese Journal of Blood Transfusion

摘　　要：目的了解产科临床用血现状从而为产科科学合理输血提供依据。方法收集本院2015年1月—2017年12月19726名产科住院患者的病历,统计其成分输血量、总输血率、异体输血率、自体输血率、大量输血率、输血不良反应率、Rh D阴性血型患者冰冻解冻去甘油红细胞使用情况,比较分析3年间产科输血的特征及其原因。结果本组2015—2017年产科输血率为3.16%(623/19726)、自体输血率1.00%(32/3176.2)、大量输血率0.14%(28/19726);2015、2017年输血率分别为2.74%(149/5442)vs 3.75%(279/7448)、自体输血率分别为0%(0/849.5)vs1.67%(25/1495.7)、大量输血率0.09%(5/5442)vs 0.23%(17/7448)(P=0.00),异体输血率分别为100%(149/149)vs 98.72%(615/623),输血不良反应率分别为3.36%(5/149)vs 1.08%(3/279)、Rh(D)阴性血液报废率分别为3.06%(26/849.50)vs 0.95%(14/1470.70)。结论随着二孩政策的实施,高龄、多产次孕产妇数量的增加,剖宫产率处于较高水平时,围产期大量输血明显增加;自体输血在产科有着广阔的应用前景。Objective To understand the current situation of blood use in obstetrics so as to provide basis for scientific and rational blood transfusion in obstetrics.Methods The medical records of 19726 obstetrical inpatients in our hospital from January 2015 to December 2017 were collected,and the relative data such as total blood transfusion rate,component blood transfusion volume,allogeneic transfusion rate,autotransfusion rate,massive blood transfusion rate,adverse reaction rate of blood transfusion and the use of frozen-thawed deglyceride RBCs in patients with Rh D-negative blood group etc.were collected.The characteristics and causes of obstetric blood transfusion in the past 3 years were compared and analyzed.Results From 2015 to 2017,the rates of obstetric transfusion,autotransfusion and mass transfusion was 3.16%(623/19726),1.00%(32/3176.2),and 0.14%(28/19726),respectively.In 2015 and 2017,the transfusion rate was 2.74%(149/5442)vs.3.75%(279/7448),autotransfusion rate was 0(0/849.5)vs.1.67%(25/1495.7),massive transfusion rate was 0.09%(5/5442)vs.0.23%(17/7448)(P=0.00),allogeneic transfusion rate was 100%(149/149)vs.98.72%(615/623),adverse reaction rate of blood transfusion was 3.36%(5/149)vs.1.08%(3/279),and the discarding rate of Rh D negative blood was 3.06%(26/849.50)vs.0.95%(14/1470.70).Conclusion Since the opening up of two-child policy,the number of older mother and multiparas as well as the cesarean section rate has increased,so increased significantly the blood transfusion rates during perinatal period.Autotransfusion has a broad application prospect in obstetrics.

关 键 词：产科输血 异体输血 自体输血 大量输血 

分 类 号：R457.1[医药卫生—治疗学] R719.8[医药卫生—临床医学]