台州市25家医院临床用血管理现状调查

Current situation survey of administration of clinical blood use in 25 hospitals in Taizhou city

目的:为进一步规范、指导医院的临床用血,提高临床输血的整体水平提供依据。方法:基本情况采用填表和现场验证的方法;临床用血采用抽查用血病历的方法,不合理输血判别依据《临床输血技术规范》附录的输血指南进行。结果:25家医院中11家设置独立输血科(血库);人员构成高级职称和医学专业分别占9.4%和11.8%;2005年三级医院每床位年均用血量(以红细胞与全血计)为7.69U,二级甲医院4.75U,二级乙医院为2.60U;有些输血申请单和记录单项目填写不完整和不规范,部分没有输血治疗同意书和输血反应情况反馈;不合理输注红细胞制品、新鲜冰冻血浆、血小板的比例分别为9.5%、51.7%、21.2%。结论:输血科(血库)设置及人员结构存在不合理现象;输血相关文书尚有缺陷;不合理输血现象仍然存在,特别是血浆不合理使用最为严重。以上情况应引起重视,需采取切实有效的措施。

Objective:To provide a basis for further standardizing and guiding clinical blood use and improving the overall level of clinical blood transfusion. Methods:The basic condition was obtained by filling in a form and on-the-spot verification; the situation of clinical blood use was got by spot checks of blood use medical records. The irrational transfusion judgement was made according to the transfusion guideline of the appendix to 《Clinical blood transfusion technology standard》. Results:11 out of 25 hospitals had established independent transfusion department(blood bank).The percentages of persons with senior technical title and medicine speciality in personnel composition were 9.4% and 11.8%, respectively. The annual blood(RBC and WB) usage per bed in AAA or BBB hospital was 7.69 U in 2005, while in AA or BB hospital was 2.60 U.There were some incomplete and irregular blood transfusion applications and transfusion records,and part of records had no blood transfusion agreement or any transfusion reaction feedback. The percentages of irrational transfusion in RBC,FFP and Plt were 9.5%,51.7% and 21.2%, respectively. Conclusion:There are irrational problems in transfusion department (blood bank)establishment and personnel composition in some hospitals. There are still some defects in blood transfusion documents. There are still irrational transfusions, especially in plasma transfusion.We should pay more attention to those problems and take some effective actions.