PDCA框架下多院区Rh血型抗原精准输注策略优化  

Optimization of Rh blood group antigen precision transfusion strategy across multiple hospital campuses by PDCA circle

作　　者：应琪明 陈鲁燕 董科迪 何意文 詹雅婷 杨叶晓青 赵枫 吕定丰 YING Qiming;CHEN Luyan;DONG Kedi;HE Yiwen;ZHAN Yating;YANG Yexiaoqing;ZHAO Feng;LYU Dingfeng(Department of Blood Transfusion,The First Affiliated Hospital of Ningbo University,Ningbo 315010,China)

机构地区：[1]宁波大学附属第一医院输血科,浙江宁波315010

出　　处：《中国输血杂志》2025年第1期106-111,共6页Chinese Journal of Blood Transfusion

基　　金：浙江省医药卫生科技项目(2024KY1495)。

摘　　要：目的探讨PDCA(持续质量改进)循环应用于提升多院区红细胞Rh血型5种抗原表型供受者符合输注率的实效性。方法收集宁波大学附属第一医院2022年5—7月临床用血资料,根据调查结果制定具体改进措施,并于2022年8月起采取PDCA循环管理模式落实措施,2022年8月—2023年10月为干预后阶段,比较2022年5—7月与干预后阶段患者Rh表型相合输注率、Rh系统抗体检出率以及Rh系统抗体在意外抗体中的占比。结果PDCA循环持续改进后,2023年8—10月Rh血型5种抗原表型供受者符合输注率为81.90%(5451/6655.5),高于2022年5—7月的70.54%(3246/4601.5)(P<0.01),并呈季度上升趋势(β=0.028,P<0.05)。Rh血型系统抗体检出率(β=-9.839×10^(-5),P<0.05)和Rh血型系统抗体在所有检出抗体中的占比(β=-0.022,P<0.05)呈季度下降趋势,并分别与Rh血型5种抗原表型供受者符合输注率呈负相关(r值分别为-0.981和-0.911,P<0.05)。结论应用PDCA循环法落实相关措施,可有效提升Rh血型5种抗原表型供受者符合输注率,减少Rh血型意外抗体的产生,从而降低输血风险,提升医疗质量与安全。Objective To explore the effectiveness of applying the PDCA(Plan-Do-Check-Act)cycle to enhance the compatibility rate of five Rh blood group antigen phenotypes between donors and recipients across multiple hospital campuses.Methods Clinical blood transfusion data from May to July 2022 were selected.Specific improvement measures were formulated based on the survey results,and the PDCA cycle management model was implemented from August 2022.The post-intervention phase spanned from August 2022 to October 2023.The Rh phenotype compatibility rate,the detection rate of Rh system antibodies,and the proportion of Rh system antibodies among unexpected antibodies were compared between the pre-intervention phase(May to July 2022)and the post-intervention phase.Results After the continuous improvement with the PDCA cycle,the compatibility rate for the five Rh blood group antigen phenotypes between donors and recipients from August to October 2023 reached 81.90%,significantly higher than the 70.54%recorded during the pre-intervention phase(May to July 2022,P<0.01),and displayed a quarterly upward trend(β=0.028,P<0.05).The detection rate of Rh blood group system antibodies(β=-9.839×10^(-5),P<0.05)and its proportion among all detected antibodies(β=-0.022,P<0.05)showed a quarterly decreasing trend,both demonstrating a negative correlation with the enhanced compatibility rate(r values of-0.981 and-0.911,respectively;P<0.05).Conclusion The implementation of targeted measures through the PDCA cycle can effectively increase the compatibility rate of five Rh blood group antigen phenotypes between donors and recipients,reduce the occurrence of unexpected Rh blood group antibodies,thereby lowering the risk of transfusion and enhancing the quality and safety of medical care.

关 键 词：PDCA循环 RH血型系统 抗原 表型 符合输注率 

分 类 号：R457.1[医药卫生—治疗学]