剖宫产手术用血分析及最大红细胞备血量目录的建立

Establishment of the maximum surgical blood order schedule for cesarean sections

目的 建立产科不同并发症剖宫产手术的最大备血量目录(MSBOS),以指导临床及输血科科学合理备血。方法 利用医院病历信息及血库系统收集并分析本院产科2021年1月~10月剖宫产手术输血数据,以产科主要并发症为分类依据,计算不同并发症(组)剖宫产手术输血率、人均红细胞输注量、输血指数(TI)等指标,参照文献方法及大出血风险,结合产科实际情况,制定本院产科MSBOS。结果 1)剖宫产术中用血疾病主要为胎盘早剥、胎盘植入、中央型前置胎盘、重度先兆子痫,输血率分别为17.9%(20/112)、17.7%(15/85)、16.8%(27/161)、5.2%(9/173),TI分别为0.9、1.3、1.0、0.3。2)建立产科MSBOS,将本院产科手术备血类型分为需要血型鉴定(T)/抗体筛选(S)、需要做T/S/交叉配血(C)2 U与需要T/S/C 4 U 3类。结论 产科MSBOS的建立使产科及输血科备(用)血更加科学合理和具有针对性。

Objective To establish the catalog of maximum surgical blood order schedule(MSBOS) for cesarean sections with different obstetric complications,so as to guide the doctors of clinical and Blood Transfusion Department to prepare blood reasonably.Methods The blood transfusion data during cesarean sections from January to October 2021 in our hospital were collected via medical record information system and blood bank system.The blood recipients were classified according to the main obstetric complications.The incidence of blood transfusion,per capita RBC transfusion units,blood transfusion index(TI) and other indicators were calculated,the literature and the risk of massive hemorrhage were referred,and the actual situation of Obstetrics Department was considered to formulate the obstetric MSBOS of our own.Results 1) The blood recipients during cesarean sections were mainly diagnosed as placental abruption,placental implantation,central placenta previa and severe preeclampsia;the incidence of blood transfusion of them was 17.9%(20/112),17.7%(15/85),16.8%(27/161)and 5.2%(9/173),respectively,and TI indexes was 0.9,1.3,1.0 and 0.3,respectively.2) The MSBOS of Obstetrics Department in our hospital had been established,and the blood preparation for obstetric surgery was divided into three categories:T(blood typing)/S(antibody screening),T(blood typing)/S(antibody screening)/C(crossmatch) 2 U,and T/S/C 4 U.Conclusion The establishment of MSBOS in Obstetrics Department of our hospital provides references for preparing blood reasonably.