武威市5所医院新鲜冰冻血浆应用的回顾性分析

Retrospective analysis on the application of fresh frozen plasma in five hospitals in Wuwei

目的了解武威地区新鲜冰冻血浆应用情况,提高临床新鲜冰冻血浆合理输注水平。方法对武威市5所不同级别的医院在2012年7月-2012年12月的输血病历按照《临床输血技术规范》的要求做回顾性调查,并对调查结果及呈相关性的因素进行统计学分析。结果武威市5所医院新鲜冰冻血浆输注占不同血液成分输注总量的比率高达34.24%;5所医院合理输注新鲜冰冻血浆的比率偏低(9.7%-15.1%),三级医院手术科室与非手术科室(χ2=10.23)有相关性,差异有统计学意义(P<0.05);不合理输注分类:无指征占比例最大(35.1%-69.9%),还有搭配输血(1.5%-14.2%)、纠正低蛋白血症(10.7%-26.1%)、补充血容量(0.4%-13.7%)、增强免疫力(1.5%-16.4%)和用量不足、输血前后未查PT、APTT(0.7%-15.6%)等。结论武威市5所医院在新鲜冰冻血浆输注方面还存在误区,临床医生还未完全掌握新鲜冰冻血浆输注适应证。

Objectives To understand the situation on the application of fresh frozen plasma in Wuwei, and to raise the reasonable standards on the clinical infusion of fresh frozen plasma. Methods A retrospective investigation was conducted on transfusion medical records in accordance with the requirements of technical specification at five varied levels of hospitals in Wuwei from July to December 2012. Statistical analysis was performed on the results from the investigation and the corre- lation factors. Results Five hospitals in Wuwei had different ratios of infusing fresh frozen plasma over the total amount of blood component transfusion, reaching as high as 34.24%. Meantime, the rate of reasonable infusion of fresh frozen plasma at these five hospitals was low （9.7% - 15.1% ）. There existed correlation between the surgical departments in tertiary, hos- pital with other non-surgical departments. （ χ2 = 10. 23 ）, as shown by the significant statistical difference （ P 〈 0. 05 ）. The classification of unreasonable infusions was listed in the descending order： lack of infusion indications （35. 1% -69. 9% ）, cross matching in transfusion （ 1.5% - 14. 2% ）, resolve hypoalbuminemia （ 10. 7% -26. 1% ）, replenishment of blood volume （0.4% - 13.7% ）, enhancement of immunity （ 1.5% - 16.4% ） , and insufficient dosage and lack of verification on the levels of PT and APTT before and after blood transfusion （0. 7% - 15.6% ）. Conclusion There were shortcomings in the infusion practice of fresh frozen plasma in all five hospitals in Wuwei. Physicians were not entirely equipped to read indi- eations from transfusion of fresh frozen plasma.