宁波市医院临床用血质量控制指标调查

Investigation analysis of clinical blood quality control indexes in hospitals of Ningbo

目的回顾性分析2019—2021年宁波市医院临床用血质量控制指标。方法自行设计宁波市医院临床用血质量控制指标调查表收集88家用血医院临床用血相关资料,包括医院血液使用、临床用血质量控制指标等,采用SPSS 22.0软件进行统计分析。结果2019—2021年宁波市医院临床用血红细胞424928.00 U,冰冻血浆385804.10 U,血小板45200.70 U。临床输血申请单合格率97.79%,受血者标本血型复查率95.66%,输血相容性检测项目室内质控率91.05%,输血相容性检测室间质评项目参加率94.08%,手术患者自体输血率48.93%,出院患者输血比例4.38%,每千单位用血输血专业技术人员数1.16人,每千输血人次输血不良反应上报例数4.74例,一二级手术台均用血量0.03 U,三四级手术台均用血量0.16 U,手术台均用血量0.07 U,出院患者人均用血量0.12 U,输血患者人均用血量2.38 U,输血患者次均用血量1.35 U。输血科(血库)专职人员研究生、本科、专科及以下比例分别为5.80%、60.78%、33.42%,不同等级医院学历比较有统计学意义(χ^(2)=55.85,P<0.01);高级、中级、初级及以下比例分别为19.61%、39.88%、40.61%,不同等级医院职称比较有统计学意义(χ^(2)=10.69,P<0.01);医师、技师、护理人员比例分别为3.59%、94.48%、1.93%,不同等级医院专业比较有统计学意义(χ^(2)=16.12,P<0.01)。结论宁波市医院手术台均用血量、出院患者人均用血量低于全国用量,输血科(血库)存在执业医师少、输血人才不足等问题,需加强人才队伍建设工作,不断提高临床用血质量。

Objective To retrospectively investigate the quality control indexes of clinical blood in Ningbo hospitals from 2019 to 2021.Methods The Questionnaire of Blood Quality Control Indicators for Clinical Use in Ningbo Hospitals was designed by ourselves,and the relevant data of blood use in 88 hospitals were collected,including blood use in hospitals and blood quality control indicators for clinical use,etc.SPSS 22.0 software was used for statistical analysis.Results From 2019 to 2021,the clinical use of red blood cells was 424928.00 U,frozen plasma 385804.10 U and platelets 45200.70 U in Ningbo Hospitals.The qualified rate of clinical blood transfusion application form was 97.79%,the blood type review rate of blood samples was 95.66%,the indoor quality control rate of blood transfusion compatibility test project was 91.05%,the participation rate of inter-quality assessment project of blood transfusion compatibility test room was 94.08%,the rate of autologous blood transfusion of surgical patients was 48.93%,and the rate of blood transfusion of discharged patients was 4.38%.There were 1.16 professional and technical personnel for blood transfusion per 1000 units,and 4.74 cases of adverse blood transfusion reactions were reported per 1000 blood transfusions.The blood use volume of the first and second operating tables was 0.03 U,the blood use volume of the third and fourth operating tables was 0.16 U,the blood use volume of the operating tables was 0.07 U,and the per capita blood use volume of discharged patients was 0.12 U.The per capita blood use volume of patients undergoing transfusion was 2.38 U,and the per time blood use volume patients undergoing transfusion was 1.35 U.The proportions of graduates,undergraduates,junior college and below in the blood transfusion department was 5.80%,60.78%and 33.42%,respectively(χ^(2)=55.85,P<0.01),and there were statistically significant differences among different levels of hospitals concerning academic qualifications.The proportions of senior title,intermediate title,primary title and below were 19.61%,39.88%and 40.61%,respectively,and there were statistically significant differences among different levels of hospitals concerning professional titles(χ^(2)=10.69,P<0.01).The proportions of doctors,technicians and nurses were 3.59%,94.48%and 1.93%,respectively,and there were statistically significant differences among different levels of hospitals concerning specialties(χ^(2)=16.12,P<0.01).Conclusion The average blood use volume per operating table and the average blood use volume of discharged patients in Ningbo are lower than those in the whole country.There are some problems in the blood transfusion department such as the shortage of licensed doctors and transfusion talents.It is necessary to strengthen the construction of talent team and improve the blood quality of clinical use.