骨科患者手术用血分析和术前最大红细胞备血量方案建立  

Analysis of orthopedic surgical blood transfusion and study on maximum surgical blood order schedule

作　　者：杨俊龙 甘新宇 张利 黎欢 彭涛 YANG Jun-long;GAN Xinyu;ZHANG Li;LI Huan;PENG Tao(Department of Blood Transfusion,the General Hospital of Western Theater Command,Chengdu 610083,China)

机构地区：[1]解放军西部战区总医院输血科,四川成都610083

出　　处：《中国输血杂志》2021年第9期982-986,共5页Chinese Journal of Blood Transfusion

摘　　要：目的建立骨科患者手术最大备血量目录(MSBOS)以指导骨科手术输血和输血科科学合理备血。方法利用医院信息系统(HIS)和输血科采供血信息软件收集本院骨科2014年~2018年择期手术申请备血量和手术输血量数据,按照手术名称分类,计算手术输血率和人均红细胞输注量,参照手术MSBOS算法和大出血风险,结合本院实际情况,建立骨科患者MSBOS。结果1)共纳入骨科择期手术3730例,术前备血总量10183.8 U,围术期输血1084例,总输血量3498.9 U,输血率29.1%(1084/3730),手术患者输血量[1~17.5(3.21±1.89)]U/例。2)建立起本院骨科手术的MSBOS,根据手术备血情况,将手术分为需要血型鉴定/抗体筛查、血型鉴定/抗体筛查/交叉配血(2~8 U)2类。结论输血科根据骨科日常手术用血情况建立MSBOS,不但有益于更科学、合理地指导骨科手术备血、保障手术安全,而且可优化血液库存管理、为建立其他用血科室手术MSBOS提供参考。Objective To establish the maximum surgical blood order schedule(MSBOS)for orthopedic surgery,as to guide the clinical blood application and reasonable blood preparation for this type of surgery.Methods The ordered and actual amount of transfused blood of orthopedic elective operations in our hospital from 2014 to 2018 were collected by the hospital information(HIS)and blood collection information software of Department of Blood Transfusion.The surgeries were classified and indices,including blood transfusion rate and per capita transfused RBC volume,were calculated,then orthopedic MSBOS was established by combining the surgical transfusion rate,per capita red blood cell infusion volume,the algorithm of MSBOS,the risk of massive hemorrhage and the actual situation of our hospital.Results A total of 3730 cases of elective orthopedic surgery were included,and the ordered blood volume was 10183.8 U.1084 cases received intraoperative blood transfusion,with the total blood transfusion volume of 3498.8 U and the blood transfusion rate at 29.1%(1084/3730).The blood transfusion volume of surgical patients was[1~17.5(3.21±1.89)]U/patient.MSBOS for orthopedic surgeries had been established in our hospital.According to the blood transfusion data of each surgical procedures,surgical blood ordering was divide into 2 categories:Type/Screen,Type/Screen/Crossmatch(2~8 U).Conclusion The establishment of MSBOS in Department of Blood Transfusion according to the daily blood use in orthopedic surgery is not only beneficial to guide the blood preparation for orthopedics surgery more scientifically and reasonably,but also can optimize the management of blood inventory and provide reference for the establishment of MSBOS in other blood use departments.

关 键 词：骨科手术输血 最大备血量 输血率 红细胞输注 患者血液管理 输血相容性试验 

分 类 号：R457.1[医药卫生—治疗学] R687[医药卫生—临床医学]