储存式自体输血的临床推广举措及成效  

Promotion measures and effectiveness of preoperative autologous blood donation

作　　者：张瀚允 陈立 肖燕妮 李忠俊 ZHANG Hanyun;CHEN Li;XIAO Yanni;LI Zhongjun(The Second Affiliated Hospital of the Army Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学第二附属医院输血科,重庆400037

出　　处：《中国输血杂志》2025年第3期442-447,共6页Chinese Journal of Blood Transfusion

基　　金：重庆市教委科学技术研究计划重大项目(KJZD-M202312802)。

摘　　要：自体输血是1种重要的血液保护策略,《医疗机构临床用血管理办法》(卫健委令第85号)规定医疗机构应积极开展自体输血技术,患者血液管理临床实践指南也提倡积极应用适宜的自体输血技术,减少对异体血液的依赖。储存式自体输血(preoperative autologous blood donation, PABD)是自体输血方式的1种,其适应证广泛,操作简单,能有效减少异体血液的输注。然而我国医疗机构开展储存式自体输血的情况并不理想,这可能与医疗机构患者的构成、输血科门诊的开展情况、重视程度以及传统型储存式自体输血不能满足临床需求等多方面因素有关。因此,改良储存式自体输血模式以及探索新型储存式自体输血技术,并推广其临床应用,是适应患者血液管理医疗模式发展需求的重要措施,同时也能缓解血液供应紧张的问题。我们就储存式自体输血模式的改良举措、新型储存式自体输血技术——术前深度单采自体红细胞和/或血小板储血技术(深度单采自体储血技术)以及目前临床应用储存式自体输血的现状进行综述,旨在为临床输血工作提供参考。Autologous blood donation is an important strategy of blood conservation.The Administrative Measures for the Clinical Use of Blood in Medical Institutions(Order No.85 of the National Health Commission)requires medical institutions to promote the implementation of autologous blood donation actively.The clinical practice guidelines for patient blood man-agement also recommend the proactive use of autologous blood donation to reduce the reliance on allogeneic blood.Preopera-tive autologous blood donation(PABD)is one of the autologous blood donation with wide range of indications,easy to oper-ate,and can effectively reduce the transfusion of allogeneic blood.However,the performance of PABD in China is unsatis-factory due to various factors such as the patient composition of medical institutions,the implementation of outpatient depart-ment of blood transfusion,the level of attention paid to this issue,and the fact that traditional PABD do not meet clinical re-quirements.Therefore,improving the PABD model and exploring new PABD technology,as well as promoting their clinical application,are critical measures to meet the development requirements of patient blood management and to alleviate the shortage of blood supply.This article summarizes the improvements in the PABD model,and a novel PABD technology of PABD—preoperative deep apheresis of autologous red blood cells and/or platelets(deep apheresis autologous blood storage technology),and the current situation of clinical application of PABD to provide paradigm for clinical transfusion.

关 键 词：储存式自体输血 推广举措 临床应用现状 

分 类 号：R457.1[医药卫生—治疗学]