凝聚胺交叉配血不合患者输血的安全管理和风险控制

Condensed safety management and risk control of transfusion in patients with amine crossmatching incompatibility

目的探讨凝聚胺交叉配血不合患者输血的安全管理和风险控制。方法 2015年10-11月通过建立健全完善输血管理规章制度,加强医务人员的专业和法律法规知识培训,提高医务人员临床输血知识水平和法律意识,使其充分认识输血风险。输用凝聚胺法交叉配血不相容血液前必须得到患方同意,签署各项知情同意书后方可实施输血治疗,输血时缓慢滴注,严密观察,一旦出现输血不良反应,立即停止输注并积极处理抢救。实行输血病历标准化书写管理,使输血医疗文书能够全面真实地反映输血全过程。结果 5例患者经原发疾病治疗和输血、对症治疗后病情好转,自觉症状减轻,无晕厥、心绞痛、胸闷症状,贫血改善,血红蛋白上升,最低者62 g/L,最高者102 g/L,未发生严重的输血不良反应和医疗纠纷。结论凝聚胺交叉配血不合患者输血相较于普通输血风险更高,只有做好系统性的安全管理和风险控制,才能提高输血疗效,减少输血风险,确保患者和医务人员的安全,避免医疗纠纷发生。

Objective To study the safety management and risk control of transfusion in patients with polybrene cross matching incompatibility. Methods Transfusion management rules were established. Professional training was strengthened on medical staffs’ transfusion knowledge and their understanding on the risk of blood transfusion. The informed consent book must be signed before the implementation of blood transfusion. Transfusion was implemented slowly with close observation.Once adverse transfusion reaction appeared,transfusion was stopped immediately and active treatment was implemented. The management of blood transfusion medical records was standardized,which could reflect the whole process of blood transfusion. Results Five patients felt symptomatic relief after blood transfusion,without experiencing the symptoms of syncope and angina. Serious adverse transfusion reactions and medical disputes did not occur. The amount of hemoglobin increased to the level between 62 g / L and 102 g / L. Conclusion Polybrene crossmatching of incompatible blood transfusion confers higher risk compared with common transfusion. A safety management system and risk control should be implemented to improve the curative effect of transfusion,reduce the risk of blood transfusion,ensure the safety of patients and medical staff and avoid the occurrence of medical disputes.