发生不合理输血的原因探讨及促进合理用血的对策

Exploration of the causes for unreasonable transfusion and the strategies to improve rational use of transfusion

目的分析发生不合理输血的品种分布情况及其发生的可能原因,探讨杜绝不合理输注的办法,进一步减少不合理输注的发生。方法统计2011-2013全年所有输血病例,对发生不合理输注的血液品种、科室分布进行统计、分析。结果 3年来不合理用血发生例逐年减少(输血合格率分别为91.61,97.34,98.33。P<0.001)。血浆在每年的不合理输注统计中仍占主要部分(分别占73.10%,62.22%,68.42%);虽然输血合格率在逐年提高,但外科系统和手术室的不合理用血例次一直占主要位置(合计2部分3年不合理用血分别占同年的58.62%,75.56%,59.65%);延于习惯、经验不足、对现代输血理论知识不熟悉是发生不合理输血的主要原因。结论通过学习、培训,加强临床用血管理,特别是加强输血医师与临床医师的沟通可大大提高临床医师科学、合理用血理念,减少不合理输注现象。

Objective To analyze the distribution of unreasonable transfusion and its possible causes,and to explore the methods to further reduce and eliminate unreasonable infusion. Methods All transfusion cases in 2011,2012 and 2013 were collected. The unreasonable infusions of different blood components and the distribution in different departments were statistically analyzed. Results The cases of unreasonable transfusion decreased year by year in the past three years. The rates of reasonable transfusion were 91. 61%,97. 34% and 98. 33% in 2011,2012 and 2013,respectively（ P〈0. 001）.Every year,plasma were the main components in unreasonable transfusion（ at 73. 10%,62. 22% and 68. 42% of total unreasonable transfusion cases,respectively）. Although the rates of rational transfusion increased year by year,unreasonable transfusion practice was mainly found in the department of surgery and operation rooms. The total rates of unreasonable transfusion in these two departments reached at 58. 62%,75. 56%,59. 65% in the past three years,respectively. The main causes for unreasonable transfusion practice were habits,lack of experience,and lack of familiar knowledge on transfusion.Conclusion Through education,training,and strengthening the management of clinical blood transfusion,in particular,enforcing the communication between transfusion physicians and clinicians,clinicians＇ traditional perspectives towards transfusion can be improved. They could learn to transfuse on a more scientific and rational basis,which could reduce the phenomenon of unreasonable transfusion practice.