石家庄地区用血医院红细胞过期报废情况分析

Status analysis of discarded red blood cells in hospitals of Shijiazhuang

目的通过对石家庄地区2013—2017年用血医院过期报废红细胞趋势分析,找出造成过期报废的原因,为保护血液资源、减少红细胞在医院过期报废量,提供数据支持和指导性建议。方法 2013—2017年通过血液中心与医院血库联网的TMIS系统,计算101家所有用血医院过期报废血的单位数,5年过期报废血共计4 427 U,并进行统计学分析,以P〈0. 05为有统计学差异。结果 2013—2015年医院过期报废血单位数和报废血千分率均呈下降趋势（965 U,666 U,436 U; 3. 52‰,2. 32‰,1. 50‰）,2016年开始回升（562 U; 1. 86‰）,2017年达到最高（1748U;5. 69‰）。2013—2017年,省市级医院用血量最大并逐年增加（193 369 U,202 563 U,204 408 U,216 671 U,223 964U）;县市级医院用血量次之,2013—2016年呈逐年增加（50 747 U,63 574 U,67 599 U,68 361 U）,2017年出现下降（51 378 U）;与县市级医院相对应的是其他医院,2013—2016年逐年下降（30 419 U,21 230 U,18 314 U,17 528 U）,2017年猛增至历年最高（31 876 U）。历年过期报废血中,郊县医院位居第一（892 U,550 U,410 U,490 U,1 205 U）,其次是省市级医院（65 U,102 U,46 U,44 U,132 U）,其他医院在2013—2016年间均位居最低（8 U,14 U,30 U,28U）,但2017年猛增至第2位,是省市级医院3倍之多（411 U）。结论为保护血液资源避免过期报废,本中心供血科与医院应在1个平台上,密切合作、及时沟通,做好血液的管理,对减少过期报废至关重要。

Objective To locate the cause of blood discard by analyzing the trend for red blood cell discard in the hospitals of Shijiazhuang from 2013 to 2017 in order to provide data reference to protect blood resources and reduce the amount of blood wasted in hospitals. Methods The units of discarded red blood cells recorded by TMIS system in 101 hospitals were calculated to be 4 427U in total. Statistics analysis was performed, and a P value of less than 0. 05 was considered significant. Results The units of expired red blood cells and permillage of red blood cells expired in hospitals both declined from 2013 to 2015（965 U,666 U,436 U;3.52%0,2. 32%0,1.50%0） and began to rise again from 2016 （562 U; 1.86%0） , reaching the peak in 2017（ 1748U ;5.69%0）. The blood demand was the largest and increased year by year in provincial from 2013 to 2017（ 193 369 U,202 563 U,204 408 U,216 671 U,223 964 U）. County and municipal hospitals ranked second in blood demand and the requirement volume increased from 2013 to 2016（ 50 747 U,63 574 U,67 599 U,68 361 U） and declined in 2017（51 378 U）. The requirement for blood in other hospitals decreased from 2013 to 2016（30 419 U,21 230 U, 18 314 U, 17 528 U） and showed an sharp increase in 2017（ 31 876 U）. In terms of discarded blood, county hospitals ranked first（ 892 U, 550 U ,410 U ,490 U, l 205 U）with provincial and municipal hospitals followed（ 65 U, 102 U ,46 U ,44 U, 132 U ）. Other hospitals ranked the lowest from 2013 to 2016 （8 U, 14 U, 30 U, 28 U） and a sharp rise again in 2017 （411 U）, ranking the second, which was more than three times the volume of the provincial and municipal hospitals. Conclusion Our blood cen- ter need to work in close collaboration with hospitals to improve blood management, which is essential to reduce discarded blood.