浙江省临床用血质量控制指标的回顾性分析与对策  

Retrospective analysis and strategy of quality control index of clinical transfusion in Zhejiang Province

作　　者：王拥军[1] 徐健[1] 韩文娟 WANG Yongjun;XU Jian;HAN Wenjuan(Department of Teaching and Research Office,Blood Center of Zhejiang Province,Clinical Blood Quality Control Center of Zhejiang Province,Hangzhou 310052,China)

机构地区：[1]浙江省血液中心业务科教科,浙江省临床用血质量控制中心,浙江杭州310052

出　　处：《全科医学临床与教育》2022年第8期735-738,共4页Clinical Education of General Practice

基　　金：浙江省重点研发计划(2020c03032)。

摘　　要：目的 回顾性分析浙江省临床用血质量控制指标,为血液安全管理提供依据。方法 采取回顾性调查方法,收集2018~2020年期间浙江省11个地市临床用血质控指标数据并进行分析。结果 共收集到1 523份临床用血质控数据统计表。基础性指标调查显示,输血申请单合格率约95.81%,受血者标本血型复查率约96.28%,输血相容性检测项目室内质控率及室间质评项目参加率分别为87.60%与95.02%,基础性指标均值与国家要求的100%存在一定差距;提升性指标调查显示,每千单位用血专业技术人员数、千输血人次输血不良反应上报例数均呈逐年递增趋势,出院患者人均用血量约0.27 U,手术台均用血量约0.08 U。在1 021家(次)基础性指标没有达标的医疗机构中,三级医疗机构258家(25.27%),二级及以下医疗机构763家(74.73%),三级医院的《临床输血申请单》合格率、受血者标本血型复查率、输血相容性检测项目室内质控率、输血相容性检测室间质评项目参加率的未达标率均明显低于二级及以下医院,差异均有统计学意义(χ^(2)分别=119.00、26.40、37.29、9.17,P均<0.05)。结论 我省部分医疗机构临床用血质量控制指标还没有达到国家要求,不同等级医院之间差异显著,加强患者血液管理,降低手术台均用血量及出院患者人均用血量是未来的发展方向。Objective To retrospective analyze the quality control index of clinical blood in Zhejiang Province,and provide basis for blood safety management. Methods The data of clinical blood quality control indexes in 11 cities of Zhejiang Province from 2018 to 2020 were collected and analyzed by retrospective investigation method. Results A total of 1523 clinical blood quality control data tables were collected.The basic index survey showed that the qualified rate of blood transfusion application form of medical institutions was 95.81%,the reexamination rate of blood type of patients for blood transfusion was 96.28%,the participation rate of internal quality control and external quality assessment were only 87.60% and 95.02%,respectively.There was a certain gap between the average value of basic index and the requirements of the state.The lifting index survey showed that the number of professionals per thousand units and the number of cases of adverse blood transfusion reactions were increasing year by year,the average blood consumption of discharged patients was 0.27 U and the blood consumption of operating tables was 0.08 U.Among the 1021 hospitals that failed to meet the basic standard,there were 258(25.27%)hospitals and 763(74.73%)second-level hospitals.The qualified rate of blood transfusion application form,reexamination rate of blood type of patients for blood transfusion,participation rate of internal quality control and external quality assessment in tertiary hospitals were significantly lower than those in secondary hospitals.There were statistically significant differences(χ^(2)=119.00,26.40,37.29,9.17,P<0.05). Conclusion The quality control index of clinical transfusion in some hospitals of Zhejiang province have not met the national requirements.There were significant differences between different level hospitals.It is the future development direction to strengthen the patients blood management and reduce the average blood consumption of the operating table and the discharged patients.

关 键 词：临床用血 质量控制指标 血液管理 

分 类 号：R197.6[医药卫生—卫生事业管理]