体外循环中限制性输血策略的质量控制与成效评价初探

Study on the quality control implementation and effect of restrictive blood transfusion in extracorporeal circulation

目的回顾总结阜外医院成人体外循环科限制性输血策略的质量控制工作,对初期成效进行评价。方法阜外医院成人体外循环科自2018年1月1日起严格执行本院外科输血规范,同时建立“临床用血核查表”电子信息系统,并基于医院电子病历系统建立围体外循环期临床数据库,对患者输血及相关信息进行全面采集。分别纳入科室质控前与质控后的体外循环患者,对比两组患者输血情况与相关临床指标。结果两组患者基线可比。与质控前相比,质控后围体外循环期红细胞输注率显著下降(P<0.05),院内死亡率与主要并发症发生率的差异无统计学意义(P>0.05)。结论通过科室内部综合质量控制方法,体外循环中限制性输血策略的安全性及有效性得到初步证实。

Objective To summarize the experience of quality control of restrictive blood transfusion strategy in Adult Extracorporeal Circulation Department of Fuwai Hospital,and to evaluate the initial results.Methods Since January 1,2018,the Adult Extracorporeal Circulation Department has strictly implemented the surgical blood transfusion guideline in our hospital.Meanwhile,we established an electronic information system of " clinical blood registration form" and a clinical database of cardiac surgery patients to comprehensively collect information.Patients with extracorporeal circulation before and after quality control were included.Blood transfusion and clinical outcomes were compared between the two groups.Results Baseline information was comparable between the two groups.Compared with information before quality control,transfusion rate in CPB was significantly reduced after quality control ( P < 0.05),and there was no statistically significant difference in the incidence of in-hospital mortality and major complications ( P >0.05).Conclusion By means of integrated quality control,the safety and effectiveness of restrictive transfusion strategy in CPB has been preliminaryly confirmed.