一家省域中心城市三甲医院临床用血适应证及输血不良反应调查  

Retrospective evaluation of clinical indications and adverse reactions of blood transfusion from a Grade-A tertiary general hospital of a provincial central city

作　　者：张鹏[1,2] 杨菁菁 李晗郡[1,2] 方华 曾飞艳[1,2] 马永能 ZHANG Peng;YANG Jingjing;LI Hanjun;FANG Hua;ZENGFeiyan;MA Yongneng(The Third People's Hospital of Mianyang,Mianyang 621000,China;Sichuan Mental Health Center)

机构地区：[1]绵阳市第三人民医院输血科,四川绵阳621000 [2]四川省精神卫生中心

出　　处：《中国输血杂志》2020年第3期259-262,共4页Chinese Journal of Blood Transfusion

摘　　要：目的了解区域中心医院输血治疗的适应证与不良反应情况,以提高临床科学合理用血水平。方法收集1家省域中心城市三甲医院2017-2018年的3027例住院输血病历资料,回顾性调查其临床用血情况,包括患者输注各种成分血的比例,以及输血适应证、输血不良反应发生情况,使用SPSS19.0软件对数据做统计学分析。结果2017-2018年,该三甲医院输血患者共计3027人次,红细胞用量最多的是消化科[26.03%(2188 U/8405.5 U)],血浆用量最多的是肝胆科[33.71%(46900 U/139110 U)],血小板用量最多的是血液科[100%(71 U/71 U)],冷沉淀用量最多的是胸外科[6.56%(176 U/378 U4)。按疾病分类,贫血红细胞用量最多[24.32%(2044 U/8405.5 U),急性炎症血浆用量最多[32.49%(32680 mL/139110 mL),慢性疾病冷沉淀用量最多[46.56%(176 U/378 U)],而血小板用量最多[47.89%(34 U/71 U)则是血小板降低原因待查。本组输血不良反应发生率1.02%(31/3027),红细胞、血浆、血小板输注均以过敏反应居多,不良反应者中男性占67.74%(21/31),反应者年龄51-80(62.06±15.43)岁。结论该省域中心医院临床用血中红细胞和血浆输注量较大,输血适应症多为贫血,输血不良发生率较低;输血科要强化用血监督力度,降低临床用血不合理事件的发生。Objective To understand the indications and transfusion reactions(TRs)of blood transfusion from a tertiary general hospital of a regional central city in Sichuan,China,so as to improve the safety and quality of blood transfusion in clinical.Methods A retrospective review was carried out on the medical records of 3027 inpatients who received blood transfusion in our hospital,between 2017 and 2018.The proportion of blood components utilization in different departments,blood transfusion indications and all the TRs were evaluated and classified.Statistical analysis was performed using SPSS19.0 software.Results During the study period,a total of 3027 times of blood transfusion were performed.The clinical departments were ranked according to the amount of blood component utilization:Department of Gastroenterology ranked first among clinical departments for red cell utilization[26.03%,2188 U/8405.5 U],Department of Hepatobiliary in plasma utilization[33.71%,46900 U/139110 U],Department of Hematology accepted all plasma products[100%,71 U/71 U],and Thoracic Surgery in cryoprecipitation utilization[46.56%,176 U/378 U].Each blood component was used for a different indication:red cells were used mostly for anemia[24.32%(2044 U/8405.5 U)];plasma for acute inflammatory[32.49%(32680 mL/139110 mL)],cryoprecipitation for chronic diseases[46.56%,176 U/378 U]and platelets for thrombocytopenia with unknown causes[47.89%,34 U/71 U].Out of the 31 cases(1.02%,31/3027)of TRs,the most common type of TRs observed was allergy.The probabilities of TRs were higher in male(67.74%,21/31)than female,and in patients aged between 51 and 80[(62.06±15.43)years old]than other age groups.Conclusion The red cells and plasma are the predominant blood components in clinical utilization of this general hospital.Anemia is the mostly common indication for transfusion and the incidence of TRs is low.Careful supervision on the process of blood transfusion should be carried on to minimize transfusion reactions.

关 键 词：临床用血 输血适应证 不合理输血 输血反应 区域中心医院 

分 类 号：R457.1[医药卫生—治疗学]