2001—2014年解放军总医院临床用血变化趋势分析

Study on the clinical blood transfusion in Chinese PLA General Hospital from 2001 to 2014

目的探讨科学合理用血经验，为进一步提高临床输血质量提供依据。方法收集2001年1月至2014年12月解放军总医院全血及各成分血用量、外科手术台数、输血总人数及外科主要成分血（红细胞、血浆与血小板）输注例次等临床资料为研究对象。分析本院2001—2014年全血及各成分血应用变化趋势，内、外科各成分血用量变化特点，外科手术红细胞、血浆及血小板输注例次及人均和台均用血量的变化规律。结果随着本院床位数增加，2001—2011年临床用血总量呈上升趋势，近3年稳中有降。其中，成分血应用比例超过本院临床用血总量的99％，全血、红细胞、血浆、冷沉淀与血小板用量分别占本院临床用血总量的0．5％，50．4％，38．6％，2．4％与8．2％。红细胞和血浆主要用于外科手术，血小板主要用于内科出血性疾病。外科患者手术台均和人均红细胞和血浆用量均比较稳定，人均血小板用量呈逐步下降趋势。结论本院2001—2011年，每年用血总量随医院床位数增加而增加，近3年（2012—2014年）则呈缓慢下降趋势，成分血应用比例合理。

Objective To summarize the experience of scientific and reasonable blood transfusion, and provide the basis for improving further quality of clinical transfusion. Methods Volume of applied whole blood and various blood components, the number of surgical operation, the total number of people who received blood transfusion, and transfusion cases of major blood components （red blood cells, plasma and platelets） in surgery and so on were studied from 2001 to 2014 in Chinese PLA General Hospital. The changes of blood application in our hospital from 2001 to 2014 were compared, and the applied trends of whole blood and every blood component and the volume of each blood component in internal and surgical department were analyzed. Whatr s more, the changes of erythrocytes, plasma and platelet transfusion cases, average volume in each surgery and each case were analyzed from 2001 to 2014. Results With the increase of the number of hospital beds, the total amount of blood transfused from 2001 to 2011 were rising, and showed steady decline in past three years. The proportion of blood components in the total amount of blood transfused was more than 99%. The proportion of whole blood, red blood cells, plasma, platelets and cryoprecipitate in the total amount of blood tranfused were 0.56%, 52.60%, 38.20%, 2.30% and 6.90%, respectively. Red blood cells and plasma were mainly used in surgical operation, while platelets were mainly used in departments of internal medicine. The average volume of red blood cells and plasma for each case and each person in operation showed steady trend, and platelets tended to decline. Conclusions As the number of hospital beds increasing, the total amount of blood transfused rised from 2001 to 2011, and showed steady decline in the past three years （2012 to 2014）. The proportion of component blood in our hospital is reasonable.