基层医院临床输血感染的风险因素调查及预防措施

Risk factors for infections induced by clinical blood transfusion in grass-roots hospitals and prevention countermeasures

目的研究基层医院临床输血感染的风险因素,并研究控制临床输血感染的预防措施,指导基层医院临床输血时控制感染的发生。方法按照卫生部《临床输血技术规范》相关要求,调查基层医院输血科室的基本现状,根据临床现状探讨和分析临床输血感染的风险因素和预防措施。结果经调查10所县级和28所乡镇级医院,县级医院各项操作均比乡镇级医院相对规范,输血科室机构的建立县级达到9所占90.00%、乡镇级9所占32.14%;建立相应管理制度的县级达到7所占70.00%、乡镇级8所28.57%;基层医院对于血液出入库登记、输血前检查、血袋保留等项目基层医院输血科室均不够完善;对于血液及血液实际的储存环境温度的记录更不完善,血液贮存设备普遍为家用冰箱,且基层医院的消毒比例较低且人员配备不足及素质较低。结论基层医院输血科医护工作人员应规范临床输血工作,开发更加灵敏高效的血液检测技术,以及控制和预防临床输血疾病的新方法和新技术,保证临床输血的安全。

OBJECTIVE To investigate the risk factors for infections induced by the clinical blood transfusion in grass-roots hospitals and put forward the prevention countermeasures so as to provide guidance for the control of clinical blood transfusion-induced infections in the grass-roots hospitals.METHODS According to the technical specification requirements for clinical blood transfusion of the Ministry of Health,the current status of the blood transfusion of the grass-roots hospitals was investigated,then the risk factors for the clinical blood transfusion-induced infections were explored and analyzed,and the prevention measures were formulated according to the current status.RESULTS Totally 10country-level hospitals and 28 township-level hospitals involved in the study,the operations of the country-level hospitals were more standard than those of the township-level hospitals;the clinical blood transfusion departments have been set in 9（90.00%）country-level hospitals and 9（32.14%）township-level hospitals;the corresponding management systems have been formulated in 7（70.00%）country-level hospitals and 8（28.57%）township-level hospitals;the registration of blood storage,examination before blood transfusion, and retention of blood bags were not satisfactory in the blood transfusion departments of the grass-roots hospitals; the records of the actual environmental temperature for blood storage were inadequate;the family refrigerator was the most commonly used device for the blood preservation;the grass-roots hospitals had lower compliance to disinfection,and the matched staff were insufficient and had low quality.CONCLUSIONIt is necessary for the medical staff of the department of hemotology to standardize the clinical blood transfusion and develop more sensitive and efficient blood test techniques and new measures to control the clinical blood transfusion-associated diseases so as to ensure the safety of clinical blood transfusion.