西南地区某三甲医院近5年血液成分使用特点及影响因素分析

Analysis of characteristics and influencing factors for blood component transfusion during the past five years in a grade A tertiary hospital of Southwest China

目的:掌握本院近5年来各种血液成分使用情况、临床主要用血科室情况,分析其影响因素,提高临床合理用血水平。方法:通过LIS系统HIS系统回顾性调查2014~2018年我院用血情况,分析变化规律和各科室用血变化趋势。结果:悬浮红细胞、血浆的用量趋于平稳,血小板、冷沉淀、去白细胞悬浮红细胞、洗涤红细胞用量逐年递增;成分输血率>99.9%;悬浮红细胞用量排名前10的科室有血液内科、ICU、消化内科等,占全院悬浮红细胞总用量的72.5%。血浆使用量排名前10的科室有感染消化科、血液内科、ICU等,占全院血浆总用量的96.34%。血小板用量排名前5的科室依次为血液内科、儿科、肿瘤科、ICU、感染消化科,占全院血小板总用量的89.9%。冰冻单采血小板、冷沉淀、洗涤红细胞使用量最多的科室是血液内科,去白细胞悬浮红细胞用量最大的是儿科。近5年全院人均用血量(0.55±0.04)U。合理用血率逐年增加,平均为63%,以血浆不合理应用最常见。结论:本院用血量近5年整体趋于平稳,成分输血率高,合理用血情况不断改善,但临床仍然存在不合理输血现象,亟待继续在各临床科室普及科学合理用血知识和提高安全用血意识。

Objective: To investigate the use of various blood components and main blood-using departments inour hospital in the past five years, and to analyze the influencing factors and improve rational use of blood. Methods: A retrospective investigation of blood use in our hospital from 2014 to 2018 was carried out through the LIS andHIS systems. The changes in the blood use of the hospital and various departments were analyzed. Results: Con-sumption of suspended red blood cells and plasma tended to be stable, while consumption increased year by year inplatelets, cryoprecipitate, leukocyte-free red blood cell suspension, and washed red blood cells. The componentblood transfusion rate was over 99.9%. The top 10 departments in consumption of suspended red blood cells includ-ed the departments of hematology, ICU, and gastroenterology, which used 72.5% of the total consumption of suspend-ed red blood cells in the hospital. The top 10 departments in plasma consumption included the departments of infec-tious gastroenterology, hematology, and ICU, which used 96.34% of the total consumption of plasma in the hospital.The top 5 departments in platelet consumption included the departments of hematology, pediatrics, oncology, ICU,and infectious gastroenterology, which used 89.9% of the total consumption of platelets in the hospital. Hematologydepartment topped the consumption of frozen apheresis platelets, cryoprecipitate, and washed red blood cells. Pediat-rics department topped the consumption of leukocyte-free red blood cell suspension. In the past five years, the percapita consumption of blood in the hospital was(0.55 ± 0.04)U. The rational blood use rate increased over years, av-eraging 63%. Plasma was the most common component of irrational use. Conclusion: In the past five years, blooduse in our hospital tends to be stable, and there is a high component transfusion rate. While rational use of blood hasbeen keeping improved, irrational blood transfusion still exists. It is urgent to continue to popularize scientific and ra-tional blood use and improve the awareness of safe blood transfusion in clinical departments.