医院合理用血回顾性调查分析

Retrospective Research and Analysis of Hospital's Rational Use of Blood

目的:通过查阅医院输血病历,了解医院临床科室用血现状,发现存在的问题并加以改进,从而提高临床科室合理用血水平。方法:依据卫生部《临床输血技术规范》,回顾性调查本院2011年1月-2012年12月输血病历428份,分析各科室用血合理性及特点。结果:医院总体用血合理性为64.72%,其中手术科室用血合理性为58.3%,内科输血合理性为98.5%,两者比较差异有统计学意义(字2=1043.91,P<0.05);手术科室中普外科、泌尿外科、脑外科、骨伤科、手足外科、妇产科用血合理性分别为31.1%、50.0%、74.1%、78.8%、90.9%、90.9%;医院不合理用血中,少量输血、搭配输血与其他不合理输血总体比例分别为3.50%、7.01%、24.77%。结论:医院临床科室用血适应证的掌握,内科好于手术科室,在手术科室中,妇科、手足外科较好,普外科、泌尿外科欠佳,说明其合理用血观念不强。

Objective：To know the current situation of use of blood at clinical departments,by consulting the Blood transfusion medical records in hospital,find and improve the problem,thereby to improve the standards of the rational use of blood at clinical department.Method：According to the technical specifications of clinical blood transfusion by Ministry of health,retrospectively researched our hospital’s blood transfusion records,which were 428 from Jan 2011to Dec 2012. Result：The hospital’s overall rationality of blood transfusion was 64.72%,in which it was 58.3%for the Surgical Intervention Dept,98.5%for the Internal Medicine Dept,the difference was statistically significant（χ^2=1043.91,P〈1043.91）. And in the Surgical Intervention Dept, for the General Surgery Dept,the Urology Surgery Departments,the Thoracic Surgery Dept ,the Bone Traumatology Dept,the Hand and Foot Surgery Dept and the Obstetrics and Gynecology Dept ,blood rationality were respectively 31.1%,50%,74.1%,78.8%,90.9%,90.9%.In hospital’s unreasonable use of blood,a small amount of blood transfusion,with blood transfusion and other unreasonable blood transfusion were respectively 3.50%,7.01%,24.77%. Conclusion：Regarding to mastering of indication for use of blood in Clinical Departments in Hospital,the Internal Medicine Dept is better than the Surgical Intervention Dept;and among the Surgical Intervention Dept,the Obstetrics and Gynecology Dept,the Hand and Foot Surgery Dept,the General Surgery Dept and the Urology Surgery Departments are not good enough. It shows that their sense of rational use of blood is not strong.