远海岛礁医院血液保障面临的问题与展望

Challenges and prospects of blood supportability in far-sea island hospitals

近年,随着健康中国战略的稳步推进和'21世纪海上丝绸之路经济带'倡议下的国际合作不断扩大,我国远海岛礁军民的医疗环境明显改善,中国应对海上灾难救援和履行国际人道主义救助的能力不断提高,面临的任务越来越多。岛礁医院作为远离大陆本土的海上医疗救治平台,担负着驻岛(礁)军民、周边海上作业者及过往舰船人员救死扶伤的重任,如何做好岛礁医院的血液保障是要解决好的重要环节。我医疗队在帮建某岛礁医院建设期间,建立了1套全程冷链条件下由陆地医院通过舰船向岛礁医院前送血液结合由驻岛军民组成'流动血库'的血液保障应急机制;2种模式基本保障了岛礁医院的备血需求。实践发现,通过舰船运送血液存在运输时间长、易受天气因素影响等问题;'流动血库'存在从采血至输血过程耗时长、中间环节多等问题。展望未来,为解决海运方式速度慢问题,空运模式是较好选择;为避免船体晃动对悬浮红细胞质量的影响,在远海岛礁医院建立冰冻红细胞血液储备库是行之有效的办法;在较大的远海医院建立自采自供的中小血站是发展方向。

In recent years,with the steady progress of'Healthy China'strategy and'Marine Silk Road Economic Belt in the 21 st Century'initiative,international cooperation has been gradually expanding,which significantly improved the medical environment of civilians and military stationed in the far-sea islands and reefs.With the constant enhancement in China′s capacity of maritime disaster relief response and international humanitarian assistance,the imminent tasks are getting increased.As important platforms for medical treatment in the far-sea depths,island hospitals are responsible for the heal-and-rescue tasks referring to civilians and military stationed in islands,surrounding maritime operators and personnel in passing naval vessels.Therefore,blood supportability in island hospitals is critical and is urged to be taken care of.During the period of construction assistance for a far-sea island hospital,on the one hand,our medical team established a blood supportability mechanism under a whole-time cold chain logistic condition,and that helped transporting blood from land hospitals to island hospitals by shipping;on the other hand,our team built a'mobile blood bank'emergency mechanism by constructers stationed in islands.The above-mentioned schemes could guarantee the blood reserve for the wounded in surgeries basically.By practice,the'mobile blood bank'still faces great challenges regarding the effectiveness and unknown tedious intermediate segments from blood collection to its transfusion,considering the frequent disturbance of weather combined with long-time transportation by shipping,etc.In the future,air transportation will be a better choice to replace the time-consuming sea transportation;expanding frozen red blood cell banks in far-sea island hospitals will be an effective approach;establishing field blood stations in larger far-sea island hospitals will be a development direction.