医源性采血对住院患者血常规结果的影响

Influence of iatrogenic blood collection on blood routine results of hospitalized patients

目的探讨医源性采血对住院患者血常规结果的影响。方法观察比较该院2019年12月419例住院患者住院前后的血常规结果的差异;统计患者住院期间的采血量,分析患者住院期间采血量与血常规变化之间的关系。结果419例住院患者住院前后白细胞计数(WBC)、红细胞计数(RBC)、血红蛋白(Hb)、血细胞比容(HCT)、红细胞平均血红蛋白含量(MCH)、红细胞平均血红蛋白浓度(MCHC)比较,差异均有统计学意义(P<0.05),表现为住院后检测结果较住院前低,并且RBC、Hb、HCT的变化与采血量有关,住院前后血小板计数(PLT)、红细胞平均体积(MCV)差异无统计学意义(P>0.05);男性患者和<70岁的患者结果与总体一致;女性患者RBC、Hb、HCT差异均有统计学意义(P<0.05),≥70岁的患者WBC、RBC、Hb、HCT、MCH差异均有统计学意义(P<0.05),其余指标差异均无统计学意义(P>0.05)。结论医源性采血对该院普通住院患者血常规结果有一定影响,但不会导致患者医源性贫血及临床行为改变。RBC、Hb、HCT的变化与采血量有一定相关性,在不影响临床诊疗的前提下,仍然有必要采取一定的措施减少医源性采血。

Objective To explore the effect of iatrogenic blood collection on blood routine results of hospitalized patients.Methods The difference of blood routine results of 419 inpatients in the hospital before and after hospitalization in December 2019 were observed and compared.The blood collection volume during hospitalization was counted,and the relationship between blood collection volume and blood routine changes was analyzed.Results There were statistically significant differences in white blood cell count(WBC),red blood cell count(RBC),hemoglobin(Hb),hematocrit(HCT),mean corpuscular hemoglobin content(MCH),and mean corpuscular hemoglobin concentration(MCHC)before and after hospitalization among 419 inpatients(P<0.05),which showed that compared with the results before hospitalization,the test results were decreased after hospitalization,and the changes of RBC,Hb and HCT were related to the blood collection volume.The differences in blood platelet(PLT)and mean corpusculer volume(MCV)before and after the hospitalization were no statistically significant(P>0.05).The results of male patients and patients less than 70 years old were consistent with the overall.The differences of RBC,Hb and HCT of female patients were statistically significant(P<0.05),and the differences of WBC,RBC,Hb,HCT and MCH in patients aged 70 years or older were statistically significant(P<0.05),and the remaining differences were not statistically significant(P>0.05).Conclusion Iatrogenic blood collection has a certain impact on the blood routine results of patients hospitalized in general wards in the hospital,but it will not cause the patient′s iatrogenic anemia and clinical behavior changes.Changes in RBC,Hb and HCT have a certain correlation with the amount of blood collected,although it does not affect clinical diagnosis and treatment,it is still necessary to take certain measures to reduce iatrogenic blood collection.