特大城市跨地域血液调剂现状与策略分析——以郑州市为例

Current situation and strategy analysis of cross-regional blood components dispatching in megalopolis——a case study of Zhengzhou

目的了解和分析郑州地区血液调剂情况,为进一步评估和完善特大城市血液调剂策略,保障临床血液供应提供依据。方法通过现代血站信息管理系统(SHINOW9.0),查询2013—2017年郑州地区跨地域血液调剂数据情况,对不同年份参与调剂的血站数、调剂血液数量及增幅、各成分血占其发放总量的比例和趋势、ABO血型分布及本地用血医院每床位年均红细胞用血量情况做研究分析。结果 2013—2017年,通过河南全省血站信息管理系统逐步整合和兼容,血液调剂效率大幅上升。河南省各地参与向郑州市调剂血液的血站数(家)增长了70%(由10增加至17);调剂血液数(袋)增长>13倍(由19 338增加至277 240);调剂血量(U)增幅>11倍(由36 334增加至464 608),其中红细胞、血浆、血小板、冷沉淀调剂血量5年增幅依次为749.9%、1 177.5%、542.8%、13 338.7%,调剂血量较多的成分主要为血浆和红细胞。各地市血站调剂给郑州的红细胞、血浆、血小板、冷沉淀血量占郑州市向临床发出成分血总量(U)的比例分别由2013年的5.0%(14 415/289 057)、7.0%(20 610/294 541.5)、2.7%(759/28 385)、1.7%(550/31 535)增长至2017年的27.9%(122 518.5/439 310.5)、47.3%(263 297.5/556 234)、8.2%(5 154/63 099)、52.2%(73 913/141 656)。通过按需实时调剂,不同年份调剂血液血型有所侧重,但5年间调剂血液量(U)ABO血型构成比分别为A型27.1%(252 400/932 158)、B型32.6%(303 777/932 158)、O型28.9%(269 932/932 158)、AB型11.4%(106 523/932 158),与郑州地区无偿献血人群血型分布基本一致。5年间,郑州市用血医院本地自采血床位年均供(用)血量(U/床)由4.0下降至3.5,在调剂血液的补充下,实际年均供(用)血量(U/床)由4.2升至4.8。结论跨地域血液调剂可补充特大城市临床用血的库存,缩短当地季节性缺血、血液偏型持续时间,从而有效缓解了特大城市常见的临床供(用)血的紧张。

Objective To understand the status of blood dispatching in Zhengzhou,and to provide a basis for further improving the strategy of blood regulation in megalopolis and ensuring clinical blood supply.Methods Statistical analysis was made on the number of blood stations participated in the blood dispatching,the amount and increase of dispatching blood,the proportion and trend of blood components in the total amount of blood dispatching,the distribution of ABO blood group and the average annual red cell consumption per bed in local medical institutions in Zhengzhou from 2013 to 2017 through SHINOW 9.0.Results From 2013 to 2017,the efficiency of blood dispatching increased dramatically on the basis of integration and compatibility of the provincial blood station information management system.The number of blood stations participated in blood dispatching in Zhengzhou increased by 70%(from 10 to 17);the number of dispatching bags increased by more than 13 times(from 19 338 to 277 240);the volume(U)of blood dispatching increased by more than 11 times(from 36 334 to 464 608).Among them,the five-year increasing rates of the volume of red blood cells,plasma,apheresis platelets and cryoprecipitation were 749.9%,1 177.5%,542.8%and 13 338.7%,respectively.The main types of blood dispatching were plasma and red blood cells.The proportion of red blood cells,plasma,apheresis platelets and cryoprecipitated blood volume dispatched to Zhengzhou increased from 5.0%(14 415/289 057),7.0%(20 610/294 541.5),2.7%(759/28 385)and 1.7%(550/31 535)in 2013 to 27.9%(122 518.5/439 310.5),47.3%(263 297.5/556 234),8.2%(5 154/63 099)and 52.2%(73 913/141 656)in 2017,respectively.According to real-time dispensing on demand,there was some emphasis on dispatching blood groups in different years.However,in the past five years,the composition ratios of dispatched ABO blood group were group A of 27.1%(252 400/932 158),group B of 32.6%(303 777/932 158),group O of 28.9%(269 932/932 158),and group AB of 11.4%(106 523/932 158),which were basically consistent with the distribution of blood group of voluntary blood donors in Zhengzhou area.In the past five years,the average annual blood consumption per bed(U/bed)relying on self-collection blood in Zhengzhou medical institutions had decreased from 4.0 to 3.5.By improving the blood dispensing mechanism and replenishing stock in time,the actual average annual blood consumption per bed(U/bed)of local medical institutions had increased from 4.2 to 4.8.Conclusion Cross-regional blood conditioning can supplement the stock of blood components in megalopolis,shorten the duration of local seasonal blood shortage,optimize the blood inventory management,and thus effectively alleviate the tension of blood supply in megalopolis.