单病种在规范择期手术备血中的应用  

Application of single disease in Standardization of blood ordering in elective surgery

作　　者：李宁[1] 毕晓琳[1] 范亚欣[1] 王忠利 马晓露 高艳[4] LI Ning;BI Xiaolin;FAN Yaxin;WANG Zhongli;MA Xiaolu;GAO Yan(Dalian Blood Center,Dalian,116001,China;The Second Hospital of Dalian Medical University;The First Affiliated Hospital of Dalian Medical University;Dalian Central Hospital)

机构地区：[1]大连市血液中心,辽宁大连116001 [2]大连医科大学附属第二医院 [3]大连医科大学附属第一医院 [4]大连市中心医院

出　　处：《临床血液学杂志（输血与检验）》2019年第6期949-951,共3页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

摘　　要：目的:根据单病种患者术中红细胞使用量,制定相应病种手术备血方案。方法:收集本市3家三甲级医院接受髋关节置换术、腰椎管狭窄减压术、子宫切除术、二尖瓣置换成形术这4种择期手术患者术前备血和实际术中输血量,用统计学软件进行分析,比较不同手术实际输血率。结果:4种手术备血量、备血人数明显多于实际输血量和输血人数。髋关节置换术T%和n%分别为2.3%、2.4%、输血备血差异度为-0.98,腰椎管狭窄减压术T%和n%分别为53.7%、65.3%,输血备血差异度为-0.46,子宫切除术分别为5.0%、2.9%、-0.95,二尖瓣置换术分别为26.8%、35.3%、-0.73。结论:外科手术备血应根据实际手术部位,手术方式,实际输血量和输血人数进行循证研究,建立择期手术患者备血策略,单病种在择期手术患者备血策略中可以提供指导性意见,推动节约用血和合理用血的有效实施。Objective:To analyze the amount of RBC used in the operation in the single disease in order to make a strategy for blood ordering. Method:The data of the amount of blood ordering and the actual blood usage intro-operation were collected and analyzed in the patients with the hip replacement,the decompression for lumbar spinal stenosis,the hysterectomy and the mitral valve surgery from 3 tertiary hospitals. Result:The amount of blood ordering and the amount of the planned transfusion patients were more than the actual blood usage and the actual transfusion patients.T%,n% and the difference between ordering units and transfusion units of the four operations were2.3%,2.4%,-0.98(the hip replacement),53.7%,65.3%,-0.46(the decompression for lumbar spinal stenosis),5.0%,2.9%,-0.95(the hysterectomy),and 26.8%,35.3%,-0.73(the mitral valve surgery),respectively.Conclusion:The surgical blood ordering schedule is proposed according to the site of operation,the surgery way,the actual blood usage and the actual requirements of patients.It has been confirmed that the single disease can provide the guidance opinion to the surgical blood ordering schedule in order to save blood and reasonable usage.

关 键 词：单病种 备血 备血策略 

分 类 号：R457.1[医药卫生—治疗学]