摘要
目的评价分析本院临床成分输血的合理性,以进一步提高临床输血质量与安全。方法抽查中山大学附属第一医院2013年各临床科室的输血病历,评价临床用血是否合理,输血记录是否完善,分析不合理用血的比例、原因以及影响因素。结果 2013年共成分输血21 496人次,抽查897例病历,不合理用血75例,合理率为91.64%。红细胞合理输注率为95.04%,主要不合理输注原因为术中失血<20%自身血容量而输注红细胞;血浆合理输注率为78.92%,主要不合理原因为术中搭配红细胞输注和术后用于促进伤口愈合;血小板和冷沉淀未出现不合理输注情况。其中,外科合理输注率偏低,为88.77%,而内科合理输注率较高,为98.83%。输血记录不完善也主要集中于外科。近年来,由于加强了输血管理,临床科室也不断改进用血水平和完善输血记录,每季度的合理用血率和输血记录完善率有所提升。结论审慎而明智地执行血液输注指征,能够降低不合理用血情况,并确保更多真正需要的患者能够输注到血液,使输血工作安全、有效、可持续发展。
Objective To analyze the appropriateness of blood component transfusion in our hospital, and to further improve the safety and quality of clinical blood transfusion. Methods Medical records of the first affiliated hospital, Sun Yat -sen University in 2013, were randomly selected. We evaluated their appropriateness and completeness, and analyzed the percentage, reasons and influencing factors of inappropriateness. Results We selected 897 cases of infusion out of total 21 496 cases, among which 75 ones were evaluated as inappropriate. The appropriateness rate was 91.64%. The erythrocyte ap- propriate infusion rate was 95. 04% and the main reason for inappropriateness was conducting infusion while intraoperative blood loss was less than 20% of patient＇s blood volume. This rate was 78.92% for plasma, the main reasons were combining transfusion with erythrocyte during operation and promoting wound recovery after operation. No inappropriateness was detected in platelets and cryoprecipitation transfusion. Among these, the surgical department showed lower appropriateness which was 88.77% while the statistics of internal department was higher, as 98.83%. The incomplete medical records were also found mainly in the surgical department. For the recent several years, the clinical departments continued to improve the rational use of blood and completeness of medical records attributing to the enhancement of blood infusion management. Conclusion Prudent tmplementation of blood infusion indications could lower of inappropriate use of blood, which assures that more pa- tients in true need can obtain blood and constructs transfusion work as safe, effective, and gains sustainable development.
出处
《现代医院》
2016年第5期694-697,共4页
Modern Hospitals
关键词
临床用血
合理率
红细胞
血浆
Clinical blood use
Appropriateness
Red blood cells （RBC）
Frozen plasma （FP）
