肿瘤患者围术期输血管理分析

Transfusion management analysis of perioperative cancer patients

背景与目的:国内外科系统的合理用血比例不足半数,肿瘤患者手术过程中易出现急性大失血,本研究旨在了解新疆医科大学附属肿瘤医院肿瘤患者术中用血情况,提高围术期合理用血水平。方法:回顾分析2012年10月—2013年12月在该院行非急诊手术并输注异体血肿瘤患者的临床资料,根据卫生部《临床输血技术规范》分析术中各科室用血合理性。结果:共纳入299例肿瘤患者,成分输血率为100%,红细胞合理性输注比例为91.8%,血浆合理性输注比例为85.0%。妇科、胃肠外科、骨科、肝胆外科、神经外科、泌尿外科和胸外科红细胞合理性输注比例分别为88.9%、91.8%、94.3%、96.3%、91.6%、100%和81.3%,血浆合理性输注比例分别为86.2%、71.8%、96.4%、78.4%、100%、100%和87.5%。结论:术中成分输血虽开展良好,但仍存在术中不合理输血现象,需对医务人员加强临床输血知识的培训。

Background and purpose：Reasonable proportion with blood less than half of the surgical system, cancer patients during surgery prone to acute massive blood loss, this study aimed to investigate blood transfusion in the patients who diagnosed with cancer during operation in the Afifliated Tumor Hospital of Xinjiang Medical University, and in order to improve the intraoperative blood transfusion and make it more scientiifc and more reasonable.Methods：The patients who were taken selective operations and heterogenous blood transfusions in the Afifliated Tumor Hospital of Xinjiang Medical University from Oct. 2012 to Dec. 2013 were enrolled, and the clinical data were retrospectively surveyed and investigated.The intraoperative use of blood components and reasonableness in each department were analyzed.Results：The medical records of 299 blood transfusion receipts proportions of reasonable transfusion of RBC from department of gastrointestinal surgery, gynecology, orthopedics, hepatobiliary surgery, neurosurgery, urological surgery and thoracic surgery were 88.9%, 91.8%, 94.3%, 96.3%, 91.6%, 100%, 81.3%,respectively. And the proportions of reasonable transfusion of plasma were 86.2%, 71.8%, 96.4%, 78.4%, 100%, 100%, 87.5%, respectively. The proportions of low-volume blood transfusion and the combined transfusion of RBC and plasma were 62.5% and 43.2% in unreasonable blood transfusion.Conclusion：Except for the unreasonableness in very few departments, the intraoperative blood component transfusion is carried on fairly well. The medical staff still should be further trained in the appropriate use of blood and strengthened the knowledge on blood transfusion.