安徽省三级综合性医疗机构内科用血合理性调查分析

Analysis of the Rationality of Blood Use in Medical Case of Class 3-A Hospital in Anhui Province

目的通过对安徽省三级综合性医疗机构2011年内科临床用血情况分析,评价本省三级综合性医疗机构内科临床用血合理性。方法对全省29家三级综合性医疗机构2011年内科临床用血情况进行回顾性调查,每家医院抽取约15份内科输血病历,每次输血根据用血合理情况给予0～10分赋值,分析临床用血的合理程度以及各临床科室、各血液品种的使用特点。结果安徽省三级综合性医疗机构内科血液制品合理输注比例为55.76%,其中红细胞悬液、血浆、血小板、全血和冷沉淀的比例分别为78.72%、14.73%、76.55%、62.50%和69.23%;443份病历总体合理的有198份,合理输注比例为44.70%,其中肾内科合理输注比例最高,为53.01%,肿瘤科最低,为26.98%;"搭配血"比例为12.64%,其中肿瘤科最高,为22.22%,肾内科最低,为3.61%。结论安徽省三级综合性医疗机构内科系统对除血浆外的血液成分输注适应证掌握较好,对血浆输注的随意性以及习惯性输注"搭配血"的现象,说明临床医生合理使用血浆的观念不强以及输注全血的陈旧观念依然存在。

Objective To evaluate the reasonable degree of blood use in departments of clinical medicine of Class 3- A comprehensive hospital in our province by analyzing the data in 2011. Methods To analyze the rationality, characteris- tics and diversities of blood use in various clinical departments and assortments by retrospective investigation on the data from 29 class 3-A comprehensive hospitals through the whole province in 2011. 15 cases of medical blood transfusion were extracted from each hospital and every time a blood transfusion would be given score from 0 to 10. Results The rate of blood products＇ rationality of the class 3-A comprehensive medical insitutions in An＇hui province was 55.76 %. The rea- sonable infusion rates of erythrocyte, plasma, platelet, whole blood and cryoprecitation were 78.72 %, 14.73 %, 76.55 %, 62.50% and 69.23%. The rate of the combined transfusion of RBC and plasm accounted for 12.64% with the oncology de- partment having the highest rate of 22.22 %, the nephrology department having the lowest rate of 3.61%. The total num- ber which was up to standard among the 443 cases was 198, the qualified propotion was 44. 70% ,the rationality of nephrology department was the highest （53.01%）while the onvology department was the lowest （26.98 % ）. Conclusion The class 3-A comprehensive hospital in AnJhui have a good grasp of the transfusion indication of blood components except plasma . The randomness of transfusing plasma and the habituation of transfusing collocated blood indicate that clinical doctors aren＇t aware of the concept of reasonable blood utilization ,and the old perception of transfusing whole blood still exist.