慢性疾病静脉采血体检者采血不良反应研究

Study on adverse reactions of blood collection in patients with chronic diseases undergoing venous blood collection

目的调查慢性疾病静脉采血体检者采血不良反应发生状况,探讨影响因素。方法采用横断面调查研究,将2021年1月至2022年6月陆军第七十三集团军医院健康体检科接收的慢性疾病静脉采血体检者3246例作为研究对象,调查采血不良反应发生状况,并收集患者临床资料,采用单因素及多因素二元logistic回归分析分析不良反应发生的影响因素。采用χ^(2)检验、t检验。结果3246例慢性疾病静脉采血体检者完成调查研究,其中男1749例、女1497例,年龄43~94(69.76±14.46)岁。共72例发生不良反应,发生率2.22%,前3种不良反应依次为晕针26例(36.11%)、穿刺部位水肿14例(19.44%)、局部血肿/渗血12例(16.67%);即时反应46例(63.89%)、延时反应26例(36.11%);轻度不良反应57例(79.17%)、中度不良反应14例(19.44%)、重度不良反应1例(1.39%)。多因素logistic分析显示,年龄(OR=1.018,95%CI 1.011~1.025,P=0.045)、性别(OR=1.476,95%CI 1.145~1.903,P=0.038)、脑血管病(OR=1.306,95%CI 1.141~1.495,P=0.026)、穿刺次数(OR=1.249,95%CI 1.184~1.317,P=0.034)是慢性疾病静脉采血体检者发生不良反应的影响因素。结论慢性疾病静脉采血体检者采血不良反应以轻度为主,即时不良反应占比较高,晕针、穿刺部位水肿、局部血肿/渗血是主要不良反应类型,高龄、女性、脑血管病及穿刺次数是慢性疾病静脉采血体检者采血不良反应的危险因素。

Objective To investigate the occurrence of adverse reactions of blood collection in patients with chronic diseases undergoing venous blood collection and to explore the influencing factors.Methods A cross-sectional survey was conducted to investigate the occurrence of adverse reactions of blood collection in patients with chronic diseases who were admitted to the Health Management Department of The 73rd Army Group Hospital,PLA from January 2021 to June 2022.The patients'clinical data were collected,and the factors influencing the occurrence of adverse reactions were analyzed by univariate and multivariate binary logistic regression analysis.χ^(2) test and t test were used.Results(1)A total of 3246 patients with chronic diseases who had undergone venous blood collection completed the study.There were 1749 males and 1497 females,aged 43-94(69.76±14.46)years.There were 72 cases of adverse reactions,with an incidence of 2.22%.The top three types of adverse reactions were needle sickness in 26 cases(36.11%),oedema at the puncture site in 14 cases(19.44%),and local haematoma/bleeding in 12 cases(16.67%).There were 46 cases(63.89%)of immediate response and 26 cases(36.11%)of delayed response.There were 57 cases(79.17%)of mild adverse reactions,14 cases(19.44%)of moderate adverse reactions,and 1 case(1.39%)of severe adverse reactions.(2)Multivariate logistic analysis showed that age(OR=1.018,95%CI 1.011-1.025,P=0.045),gender(OR=1.476,95%CI 1.145-1.903,P=0.038),cerebrovascular disease(OR=1.306,95%CI 1.141-1.495,P=0.026),and number of punctures(OR=1.249,95%CI 1.184-1.317,P=0.034)were the influencing factors of adverse reactions in patients with chronic diseases undergoing venous blood collection.Conclusions The adverse reactions of blood collection in patients with chronic diseases undergoing venous blood collection are mainly mild,while the immediate adverse reactions account for a relatively high proportion.Needle sickness,oedema at the puncture site,and local haematoma/bleeding are the main types of adverse reactions.Advanced age,female,cerebrovascular disease,and number of punctures are the risk factors of adverse reactions of venous blood collection in patients with chronic diseases.