成都市血液中心单采血小板耗材报废原因的调查

Analysis of scrapping reasons for apheresis platele consumables used in Chengdu Blood Center

目的 探讨成都市血液中心使用的3种型号血细胞分离机配套单采血小板耗材的报废原因.方法 选择2015年1月至2017年12月于成都市血液中心本部和天府献血屋所使用的63782套单采血小板耗材为研究对象.其中,MCS+、Amicus、Trima Accel型血细胞分离机的配套原装一次性单采血小板耗材分别为28351、15482和19949套.采用回顾性调查方法,通过启奥血站管理系统查询成都市血液中心本部和天府献血屋资源管理中的物料报废情况,统计单采血小板耗材的报废数量和原因,并且与人工登记的《机采室耗材报废统计记录》资料进行核对.单采血小板耗材的报废原因包括耗材因素(管路扭曲折皱、破损、渗漏等)和采集因素(静脉穿刺失败、机器故障、乳糜血、红细胞溢出、献血反应等).资料核实无误后,计算血小板单采耗材的报废率.采用χ^2检验对不同型号血细胞分离机、不同报废原因的单采血小板耗材报废率分别进行比较.结果 ①本研究63782套单采血小板耗材中,共报废900套,报废率为1.41%(900/63782).其中,MCS+型血细胞分离机配套单采血小板耗材的报废率最高(1.83%,518/28351),分别高于Amicus和Trima Accel型的1.41%(219/15482)和0.82%(163/19949),并且差异均有统计学意义(χ^2=239.10,P<0.001;χ^2=162.15,P<0.001).②本研究900套报废的单采血小板耗材中,采集因素报废率为1.16%(738/63782),高于耗材因素的0.25%(162/63782),并且差异有统计学意义(χ^2=304.28,P<0.001).因采集因素报废的738套耗材中,MCS+型血细胞分离机配套单采血小板耗材的采集因素报废率最高(1.61%,456/28351),分别高于Amicus和Trima Accel型的0.96%(148/15482)和0.67%(134/19949),并且差异均有统计学意义(χ^2=220.79,P<0.001;χ^2=164.42,P<0.001).因耗材因素报废的162套耗材中,Amicus型血细胞分离机配套单采血小板耗材的耗材因素报废率最高(0.46%,71/15482),分别高于MCS+和Trima Accel型的0.22%(62/28351)和0.15%(29/19949),并且差异亦均有统计学意义(χ^2=19.05,P<0.001;χ^2=30.38,P<0.001).③本研究因采集因素报废的738套单采血小板耗材中,主要报废原因包括静脉穿刺失败报废241套(0.38%,241/63782),机器故障报废144套(0.23%,144/63782)和乳糜血报废133套(0.21%,133/63782).结论 成都市血液中心使用的3种型号血细胞分离机配套单采血小板耗材的报废率和报废原因存在差异,报废原因主要以采集因素为主,包括静脉穿刺失败、机器故障和乳糜血等.单采血小板采集工作中,应根据献血者的身体条件及血细胞分离机的特性,选择适合的血细胞分离机及其配套单采血小板耗材进行采集.

Objective To explore the scrapping reasons for the apheresis platele consumables of 3 different types blood cell separators used in Chengdu Blood Center.Methods From January 2015 to December 2017,a total of 63782 sets of apheresis platelets consumables used in Chengdu Blood Center and Tianfu Blood Donation House were selected as subjects.Among them,the apheresis platelets consumables of MCS+,Amicus,Trima Accel blood cell separators were 28351,15482 and 19949 sets,respectively. Retrospective investigation method was adopted to inquire the material scrapping situation in the resource management of Chengdu Blood Center and Tianfu Blood Donation House,through the Qiao Blood Station Management System.And the scrapping amount and reasons of apheresis platele consumables were counted,and were checked with the scrapping records from Consumables Scrap Statistics in Apheresis Room.Reasons for scrapped of apheresis platele consumables include consumable factors (pipe wrinkles,breakage,leakage, etc.)and collection factors (venipuncture failure,machine fault,chylemia blood,red blood cell overflow, blood donation response,etc.).After the data were verified correctly,the scrapping rates of apheresis platelets consumables were calculated.The scrapping rates of different blood cell separators and different scrapping reasons were compared by chi-square test,respectively.Results ① Among the 63782 sets of apheresis platelets consumables,a total of 900 sets were scrapped,with a scrapping rate of 1.41% (900/63782).The scrapping rate of MCS+ blood cell separators was 1.83% (518/28351),which was higher than that of 1.41% (219/15482)of Amicus and 0.82% (163/19949)of Trima Accel blood cell separators, and the differences were statistically significant (χ^2 =239.10,P <0.001;χ^2 =162.15,P <0.001 ).② Among the 900 sets of scrapping apheresis platelets consumables of this study,the scrapping rate due to collection factors was 1.16% (738/63782),which was higher than that of 0.25% (162/63782)due to consumables factors,and the difference was statistically significant (χ^2=304.28,P<0.001).Among the 738 sets of scrapping apheresis platelets consumables due to collection factors,the scrapping rate of MCS+blood cell separators was 1.61% (456/28351),which was higher than that of 0.96% (148/15482)of Amicus and 0.67% (134/19949)of Trima Accel blood cell separators,and the differences were statistically significant (χ^2=220.79,P<0.001;χ^2=164.42,P<0.001).Among the 162 sets of scrapping apheresis platelets consumables due to consumables factors,the scrapping rate of Amicus blood cell separators was 0.46% (71/15482),which was higher than of 0.22% (62/28351)of MCS+ and 0.15% (29/19949)of Trima Accel blood cell separators,and the differences were statistically significant (χ^2=19.05,P<0.001;χ^2=30.38,P<0.001 ).③ Among the 738 sets of scrapping apheresis platelets consumables due to collection factors,venipuncture failure (0.38%,241/63782),machine fault (0.23%,144/63782)and chyle blood (0.21%,133/63782)were main scrapping reasons.Conclusions There are differences in the scrapping rate and reasons of apheresis platele consumables scrapping of 3 types of blood cell separators used in Chengdu Blood Center.The reasons for scrapping are mainly the collection factors,including venipuncture failure,machine failure and chyle blood.In the work of apheresis platelets collection,the appropriate blood cell separators and matching apheresis platelets consumables,should be selected according to the physical conditions of the blood donors,as well as the characteristics of the blood cell separators.