患者血液管理在提高自体输血率的应用研究  

The Application Research of PBM in Improving the Rateof Autologous Blood Transfusion

作　　者：孙少君 王凯丽 梅子娣 王秋波 SUN Shaojun;WANG Kaili;MEI Zidi;WANG Qiubo(Department of Blood Transfusion,Wuxi Ninth Hospital Affiliated to Soochow University,Wuxi 214000,China)

机构地区：[1]无锡市第九人民医院输血科,江苏无锡214000

出　　处：《标记免疫分析与临床》2024年第11期2105-2109,2157,共6页Labeled Immunoassays and Clinical Medicine

基　　金：江苏省卫生健康委员会医学科研立项面上项目(编号:H2023093);无锡市卫生健康委员会中青年拔尖人才资助计划(编号:BJ2023109)。

摘　　要：目的探讨患者血液管理(PBM)策略在提高自体输血率的应用。方法回顾性分析省骨科区域医疗中心2023年1月至2024年6月手术患者。PBM包括术前贫血管理、减少术中失血、限制性输血等策略,根据实施时间,将患者分为实施前组和实施后组,分析在提高自体输血率取得的成效。结果19465例患者纳入分析,其中实施前组9618例,实施后组9847例。实施前后比较,红细胞输注率分别为14%vs 11%,人均红细胞用血量分别为0.32 U vs 0.22 U;平均住院日、术前平均住院日、术后平均住院日均明显缩短(P<0.001)。围手术期患者异体输血量和输血率总体呈稳步下降状态,自体输血率呈逐渐上升趋势。重点手术科室,人均红细胞用血量均呈下降状态,实施前后分别为0.68 U vs 0.50 U;用血量排名第一的创伤骨科异体输血量下降29.14%,自体输血量提高28.40%,自体输血率上升9.88%。结论PBM显著降低手术患者异体输血量,提升自体输血量,从而提高自体输血率,促进临床合理输血。Objective To explore the application value of patient blood management(PBM)strategies in increasing the rate of autologous blood transfusion.Methods A retrospective analysis was conducted among surgical patients in the Provincial Orthopedic Regional Medical Center from January,2023 to June,2024.PBM included strategies such as preoperative anemia management,reducing intraoperative blood loss,and restrictive blood transfusion.According to the implementation time interval,the patients were divided into the pre-implementation group and the post-implementation group,and the effectiveness achieved in increasing the rate of autologous blood transfusion was evaluated.Results A total of 19465 patients were included in the analysis,including 9618 in the pre-implementation group and 9847 in the post-implementation group.Compared before and after implementation,the red blood cell transfusion rates were 14%vs.11%respectively,and the average red blood cell usage per person was 0.32U vs.0.22U respectively;The average length of hospital stay,the average preoperative hospital stay,and the average postoperative hospital stay were all significantly shortened(P<0.001).The allogeneic blood transfusion volume and transfusion rate of perioperative patients showed a steadily decreasing trend overall,while the autologous blood transfusion rate showed a gradually increasing trend.In key Surgical Departments,the average red blood cell usage per person showed a decreasing trend,which was 0.68U vs.0.50U before and after the implementation;In the Trauma Orthopedics Department,which ranked first in blood usage,the allogeneic blood transfusion volume decreased by 29.14%,while the autologous blood transfusion volume increased by 28.40%,and the autologous blood transfusion rate increased by 9.88%.Conclusion PBM can significantly reduce the allogeneic blood transfusion volume of surgical patients and increase the autologous blood transfusion volume,thereby increasing the rate of autologous blood transfusion and promoting rational clinical blood tr

关 键 词：患者血液管理 围手术期 自体输血率 

分 类 号：R457.1[医药卫生—治疗学]