急诊用血可及性现状及分析  

The status and analysis of blood accessibility for emergency physicians

作　　者：吕冬梅 伍国俊[1] 赵会民[1] 郑晓文[1] 张剑锋[1] 张猛[1] 苏谐 LV Dongmei;WU Guojun;ZHAO Huimin;ZHENG Xiaowen;ZHANG Jianfeng;ZHANG Meng;SU Xie(Department of Emergency,the Second Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi 530007,China;Department of Hematology,the Second Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi 530007,China)

机构地区：[1]广西医科大学第二附属医院急诊科,南宁530007 [2]广西医科大学第二附属医院血液内科,南宁530007

出　　处：《重庆医学》2021年第24期4261-4265,共5页Chongqing medicine

基　　金：广西重点研发计划项目(桂科AB17195002)。

摘　　要：目的了解我国急诊用血可及性现状,探讨改进策略。方法采用自愿抽样法,通过中华医学会急诊分会、中国医师协会急诊医学分会、急救复苏和灾难医学专委会等学术团体向全国急诊医师发放电子调查问卷,汇总信息后进行统计分析。结果(1)共获得有效答卷1591份,东部、中部、西部各占50.2%、18.4%、31.5%,三级医院占83.7%、二级及以下医院占16.3%,受访者高级、中级、初级职称占比分别为29.5%、29.2%、41.4%。(2)过去1年内53.7%的医师遭遇过无法及时获得足量抢救用血的情况,中西部地区或二级以下医院发生率更高;容易发生供应紧张的品种主要是血小板、红细胞、全血;从申请输血到血液进入患者血管需时在0.5 h内占28.0%,2 h内占91.3%,中西部地区等待时间偏长(P<0.05),不同等级医院间差异无统计学意义;61.0%的受访者经历过血液库存耗竭,近28.6%能在4 h内恢复,二级以下医院或者中西部地区需时更长(P<0.05)。(3)影响因素主要是:献血不足(51.7%)、医疗需求增长(23.8%)、超保质期浪费(8.5%)、临床不合理使用(6.0%)。(4)改善建议包括:加强无偿献血(47.0%)、研发血液替代品(26.1%)、规范临床用血(19.0%)、改进血液存储技术(7.9%)。结论现阶段我国临床供血尚不能完全满足急诊用血需求,中西部和二级及以下医院更容易遭受血液供应不足的威胁,有必要采取综合措施进一步改善急诊用血可及性。Objective To investigate the status of blood transfusion accessibility for emergency physicians in China and explore the strategies to improve it.Methods The voluntary sampling method was adopted to distribute the electronic questionnaire to the emergency physicians in China through the academic organizations such as the Emergency Physician Branch of the Chinese Medical Doctor Association,the Emergency Resuscitation and Disaster Medicine Committee of the Chinese Medical Doctor Association to summarize information and make statistical analysis.Results(1)A total of 1591 valid questionnaires were collected from 31 provinces,municipalities or autonomous regions except Hong Kong,Macao and Taiwan,accounting for 50.2%,18.4%,32.5%respectively in the east,middle and west regions.The tertiary hospitals accounted for 83.7%,and secondary and lower hospitals accounted for 16.3%.The participants with the senior position titles take up 29.5%while those with the intermediate and junior position titles come to 29.2%and 41.4%respectively.(2)In the past year,there were 53.7%of physicians had not been able to obtain sufficient blood in a timely manner,and the incidence was higher in the central and western regions or secondary and lower level hospitals.The platelets and red blood cells or the whole blood were the main varieties prone to the tight supply.The time from applying for blood transfusion to that the blood were injected to the patient′s blood vessel accounted for 28.0%within 0.5 h and 91.3%within 2 h.The waiting time in the central and western regions was too long(P<0.05),and the difference in the hospital grade was not statistically significant.There was 61.0%of the respondents who had experienced blood inventory depletion,and nearly 28.6%could recover within 4 hours,and it took longer for the secondary and lower-level hospitals or the central and western regions(P<0.05).(3)The influencing factors were the insufficient blood donation(51.7%),increased medical demand(23.8%),short shelf life of blood(8.5%)and unreasonable c

关 键 词：急救 输血 临床供血 临床用血 无偿献血 血液替代品 

分 类 号：R457.1[医药卫生—治疗学]