异基因造血干细胞移植术后安全输血策略的构建与应用

Designing and Application of Strategies for Transfusion Safety after Allogeneic Hematopoietic Stem Cell Transplantation

目的探讨异基因造血干细胞移植术(allogeneic hematopoietic stem cell transplantation,allo-HSCT)术后安全输血策略的应用效果。方法便利抽样法选择2015年1月至2017年1月鼓楼医院收治的allo-HSCT术后患者为研究对象,按住院时间段将患者分为对照组(12例,2015年1月至2016年1月)和观察组(17例,2016年2月至2017年1月)。对照组患者按常规方法输血,观察组患者在常规的基础上实施安全输血策略输血,比较两组患者输血潜在安全风险发生率、输血操作规范性及核对效率。结果对照组患者共输血279次,观察组患者共输血261次。对照组中,护士双人核对及时发现错误6例,占2.15%,其中2例未填写与患者ABO血型不同的申请血液成分的血型,4例未注明血液辐照要求;观察组无1例患者发生上述情况,差异有统计学意义(χ~2=3.887,P=0.049)。两组护士在输血操作规范评分及核对时间上的差异均有统计学意义(均P<0.01)。结论构建并应用allo-HSCT术后安全输血策略,可以保证患者输血安全,规范护理行为,提高护理质量。

Objective To explore the effect of strategies for transfusion safety after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods By convenience sampling,allo-HSCT patients admitted in drum tower hospital from January 2015 to January 2017 were selected and divided into the control group(n=12,January 2015 to January 2016)and the observation group(n=17,February 2016 to January 2017).The control group received routine transfusion method,while the observation group received transfusion administered with safety strategies.Results The control group received 279 times of transfusion,while 261 times in the observation group.Nurses found 6 cases of error in the control group by double check,which accounted for 2.15%.Among 6 error cases,the application form of blood component different from patient’s ABO blood type were not filled in 2 cases and failure of indicating blood irradiation requirements in 4 cases.However,No such adverse event was found in the observation group(χ2=3.887,P=0.049).In addition,there was statistically significant difference in the score of standard transfusion operation and checking time between two groups of nurses(all P<0.01).Conclusion Designing and application of strategies for transfusion safety after allo-HSCT can ensure the safety of transfusion,standardize nursing behavior and improve the quality of care.