全血采集质量监测系统的建立和初步应用

Establishment and Preliminary Application of Quality-Monitoring System for Whole Blood Collecting

目的 通过建立全血采集质量监测系统,探索全血采集过程中质量信息的正确收集和分析方法,旨在达到从起始血液就对血液质量进行管理,并将此系统应用于采血工作的指导和改进.方法 选择2013年1月1日至2013年12月31日,于珠海市中心血站采集的19 188袋全血为研究对象.合理设置全自动采血混合仪的工作参数,开发与之匹配的计算机软件.利用网络技术,建立监测系统,并利用所建立的系统获取研究对象收集时间段内所有全血的采集信息,以分析监测系统的工作和初步应用情况.结果 监测系统完整获取并处理19 063袋全血数据,占99.35％（19 063/19 188）,其中5 283袋在采集时发生异常情况,包括采集过程中出现流量报警的全血为5 261袋,占27.60％（166/19 063）;出现采集过程中断的全血为22袋,占0.12％（22/19 063）.采集量不合格的全血为166袋,占0.87％（166/19063）,合格全血为18 897袋,占99.13％（18 897/19 063）.18 897袋合格全血中,不能用于制备手工血小板为1 289袋,占合格全血袋数的6.82％,不能制备新鲜冰冻血浆的为454袋,占合格全血袋数的2.40％.本组19 063袋全血的采集的平均流量为（71.42±20.91） mL/min,平均流量正常值应≥30.44 mL/min; 400 mL、300 mL、200mL规格全血采集平均流量分别为（77.34±19.44）mL/min、（70.21±20.62）mL/min、（65.38±20.95）mL/min,3个规格的全血采集平均流量比较,差异有统计学意义（F=604.51,P＜0.05）;200mL规格全血的平均流量小于300 mL规格和400 mL规格（q=-12-38,-34.17;P＜0.05）,300 mL规格全血的平均流量小于400mL规格（q=-19.81,P＜0.05）.结论 本研究建立的监测系统运行稳定,具有良好和广泛的应用价值和前景,其应用能够防止不合格全血采集的发生,且为改进实际采血工作提供指导,并为采供血机构提供大量研究数据.

Objective To explore the proper way of collection and analysis of quality information in whole blood collecting process,by establishing the quality-monitoring system,in order to manage the blood quality from the initial blood and to guide and improve the blood-collecting.Methods From January 1st,2013 to December 31st,2013,a total of 19 188 bags whole blood collected in Zhuhai Central Blood Bank were collected as study objects.Reasonable work parameters of automatic blood-collecting mixer were set up and computer software which matched the parameters was developed.To establish the monitoring system as well as to access all the whole blood collecting information in the period of study objects collection,in order to analyze the preliminary application results and work conditions of the monitoring system by using the network technology.Results The data of 19 063 bags whole blood were obtained and processed,accounting for 99.35%.5 283 bags occurred abnormal situations in whole blood collecting process,including 5 261 bags with flow alarm,accounting for 27.6%; and 22 bags with blood sampling interrupt,accounting for 0.12%.The whole blood with inappropriate amount of blood collected were 166 bags,accounting for 0.87%,and appropriate amount of blood collected were 18 897 bags,accounting for 99.13%,of which 1 258 bags cannot be used to prepare hand-made platelet,accounting for 6.82%,and 454 bags cannot be used to prepare fresh frozen plasma,accounting for 2.40%.The average flow of all the 19 063 bags whole blood collecting was （71.42±20.91） mL/min.The normal value of average flow should be equal to or more than 30.44 mL/min.The average flow of 400 mL,300 mL and 200 mL whole blood were （77.34±19.44） mL/min,（70.21 ± 20.62） mL/min and （65.38 ± 20.95） mL/min,respectively.There was significant statistical difference of average flow of whole blood collecting among these 3 packaging sizes （F=604.51,P〈0.05）.Average flow of whole blood collecting in 200 mL packaging size was less than that in 300 mL and 400 mL packaging size （q=-12-38,-34.17;P〈0.05）.Average flow of whole blood collecting in 300 mL packaging size was less than that in 400 mL packaging size （q=-19.81,P〈0.05）.Conclusions The monitoring system we established is smoothly operated with good outlook and extensive application value.Its application could not only prevent substandard blood collecting from occurring,but also provide guidance for improving work and a lot of study data for blood-collecting institutions.