缩短临床领取新鲜冰冻血浆等待时间在患者血液管理中的应用  

Application of shorten waiting time for clinical receiving fresh frozen plasma in patient blood management

作　　者：杨晓亮[1] 徐丹丹 李鑫[1] 阙文君 谭兵[1] 余泽波[1] Yang Xiaoliang;Xu Dandan;Li Xin;Que Wenjun;Tan Bing;Yu Zebo(Department of Transfusion,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院输血科,400016

出　　处：《国际输血及血液学杂志》2020年第4期345-350,共6页International Journal of Blood Transfusion and Hematology

摘　　要：目的探讨缩短临床领取新鲜冰冻血浆(FFP)等待时间在患者血液管理(PBM)中的应用。方法选择2017年4月至11月,于重庆医科大学附属第一医院接受FFP输注治疗的4974例患者的临床病例资料为研究对象。根据缩短临床领取FFP等待时间整改措施的实施进程,将研究对象分为初步整改阶段组(n=2303,FFP领取时间为2017年6月至8月),持续整改阶段组(n=2048,FFP领取时间为2017年9月至11月),对照组(n=623,未实施相关整改措施,FFP领取时间为2017年4月至5月)。通过调查对照组和初步整改阶段组的临床病例资料,分析FFP领取环节中存在问题及其原因,制定缩短临床领取FFP等待时间的初步和持续整改措施。统计各组临床领取FFP的平均等待时间,以及初步整改阶段组和持续整改阶段组的预解冻FFP报废率和出库时间。3组临床领取FFP平均等待时间的总体比较,采用Kruskal-Wallis H检验,组间两两比较采用Mann-Whitney U检验,两两比较的检验水准校正采用Bonferroni校正法。初步整改阶段组与持续整改阶段组的预解冻FFP报废率比较,采用χ^2检验。结果①本研究中,持续整改阶段组、初步整改阶段组、对照组的全院临床领取FFP中位等待时间分别为8.0 min(5.0~14.8 min)、11.0 min(4.0~18.0 min)、19.0 min(16.0~23.0 min),3组总体比较,差异有统计学意义(χ^2=239.862,P<0.001);初步整改阶段组、持续整改阶段组与对照组分别比较,差异均有统计学意义(Z=-11.651,P<0.001;Z=-15.986,P<0.001)。3组的危重患者科室临床领取FFP中位等待时间分别为8.0 min(5.0~13.0 min)、11.5 min(4.0~17.0 min)、20.0 min(17.0~23.0 min),3组总体比较,差异有统计学意义(χ^2=150.978,P<0.001);初步整改阶段组、持续整改阶段组与对照组分别比较,差异均有统计学意义(Z=-9.225,P<0.001;Z=-12.602,P<0.001);初步整改阶段组与持续整改阶段组比较,差异亦有统计学意义(Z=-2.176,P=0.030)。②初步整改阶段组预解冻Objective To explore the applications of shorten waiting time for clinical receiving fresh frozen plasma(FFP)in patient blood management(PBM).Methods From April to November 2017,a total of 4974 copies of clinical data from patients who receiving FFP infusion treatment in the First Affiliated Hospital of Chongqing Medical Universityin were selected as research subjects.According to the implementation of rectification measures for shorten waiting time for clinical receiving FFP,the research subjects were divided into preliminary rectification stage group(n=2303,FFP receiving date was from June to August 2017),continuous rectification stage group(n=2048,FFP receiving date was from September to November 2017),and control group(n=623,not implemented any rectification measures,FFP receiving data was from April to May 2017).By investigating the clinical data of the control group and preliminary rectification stage group,analyzed the problems and their causes existing in clinical receiving FFP,and formulated preliminary and continuous rectification measures to shorten waiting time for clinical receiving FFP.Calculate the average waiting time for clinical receiving FFP in each group,as well as the scrap rate and outbound time of pre-thawed FFP in preliminary rectification stage group and continuous rectification stage group.The overall comparison of the average waiting time for clinical receiving FFP among the three groups,was performed using the Kruskal-Wallis H test.The pairwise comparison between groups was performed using the Mann-Whitney U test,and the test level correction of the pairwise comparison was performed using the Bonferroni correction method.The comparison of scrap rate of pre-thawed FFP between preliminary rectification stage group and continuous rectification stage group was performed using Chi-square test.Results①In this study,the median waiting time for clinical receiving FFP of whole hospital in the continuous rectification stage group,preliminary rectification stage group,and control group were 8.0

关 键 词：血浆 新鲜冰冻血浆 患者血液管理 报废率 预解冻 血液发放流程 

分 类 号：R457.1[医药卫生—治疗学]