基于闭环输血信息管理和血库前移构建手术用血智慧管理体系

Establishment of intelligent management system of surgical blood based on closed-loop blood transfusion information management and blood bank forward system

目的构建手术用血智慧管理体系,探讨该体系在促进手术患者合理用血和及时用血方面的有效性。方法基于医院HIS闭环式输血信息管理系统、临床输血移动护理APP系统,并联合物联网血库前移管理系统,构建手术用血智慧管理体系,对围术期输血管理全过程进行动态指导、监管与评价。选取手术用血智慧管理体系应用前(2018年5~10月)后(2018年11月~2019年4月)各100例心脏大血管手术患者用血管理数据,并进行比较,以评价该体系在手术用血管理中的作用。结果术中用血从发起申请到输注,由实施前的30 min缩短到不足2 min;心脏大血管手术患者术中输血后血红蛋白超过110 g/L比例明显降低,由智慧管理体系实施前的30.5%(25/82)降低至8.5%(4/47)(P<0.01);手术备血使用率由原来的82.0%(82/100)下降至47.0%(47/100)(P<0.01)。结论手术用血智慧管理体系实施后,创新了手术患者临床用血管理模式,促进了患者术中及时用血和合理用血,对提升手术安全具有重要意义。

Objective To establish an intelligent management system of surgery blood(IMSSB) and explore its effectiveness in promoting rational and timely blood transfusion in surgical patients. Methods IMSSB was constructed based on the hospital closed-loop blood transfusion information management system, clinical transfusion mobile nursing APP system, and the Internet of Things blood bank forward management system to dynamically guide, supervise and evaluate the whole process of perioperative blood transfusion management. Blood management data of 100 patients undergoing cardiac vascular surgery before( from May to October, 2018) and after(from November 2018 to April 2019) the application of IMSSB were selected and compared to evaluate the role of the system in the management of surgical blood. Results Time, from blood application to transfusion, during surgery was shortened(30 minutes before vs less than 2 minutes after). The proportion of patients with Hb over 110 g/L after intraoperative blood transfusion decreased significantly from 30.5%(25/82) to 8.5%(4/47)(P<0.01). The incidence of surgical blood transfusion decreased from 82.0%(82/100) to 47.0%(47/100)(P<0.01). Conclusion IMSSB, as an innovation of clinical blood management mode for surgical patients, can promote timely and rational blood transfusion during operation, which is of great significance to improve operation safety.