南宁市输血依赖性地中海贫血(TDT)患者血液保障及“以供定采”管理分析

Blood security and management of transfusion-dependent thalassaemia(TDT)patients in Nanning:analysis of"collection-based-supply"blood management mode

目的 回顾性统计分析南宁市户籍输血依赖性地中海贫血(transfusion-dependent thalassemia, TDT)患者2018-2023年在9家定点输血医疗机构用血情况,评估“三定”输血模式及“以供定采”血液管理模式对TDT患者的血液保障效果。方法 实施定点、定人、定时的“三定”输血模式,确保本地户籍登记在册(简称“名册”)TDT患者获得定点医疗机构门诊输血权益及血液保障。实施“以供定采”血液管理模式对“名册”TDT患者用血需求做精细化评估,并依据血液库存量(采集)最大限度予以满足。结果 2018-2023年“名册”TDT患者合计供血占所有医疗机构供应红细胞总供血量10.37%(138 509.5 U/1 335 788.0 U);其中O型血占比最高为46.34%(64 181.0 U/138 509.5 U),AB型血占比最低为3.85%(5 331.0 U/138 509.5 U)。2018年已经设立9家TDT患者定点输血医疗机构,“名册”TDT患者合计766人,人均年输血量由2018年的20.28 U(15 531.0 U/766人)提升至2023年的36.01 U(27 586.0 U/766人),每年同比均保持正增长(+30.26%,+4.94%,+11.71%,+8.61%,+7.10%)。结论 实行“三定”输血模式及“以供定采”血液管理模式能有效保障TDT患者血液供应。

Objective To retrospectively analyze the blood use of transfusion-dependent thalassemia(TDT)patients in 9 designated transfusion medical institutions from 2018 to 2023 in Nanning,and to evaluate the effect of"three designated"blood transfusion mode(hereby means TDT patients undergoing blood transfusion in designated transfusion medical institutions regularly)and"collection-based-supply"blood management mode on blood security of TDT patients.Methods The"three designated"blood transfusion mode was implemented to ensure that TDT patients registered in the local household registration(referred to as the"register")obtain the rights and interests of outpatient transfusion and blood security of designated medical institutions.The"collection-based-supply"blood management mode was implemented to assess the blood needs of“register”TDT patients and meet their needs to the maximum extent according to the blood inventory(collection).Results From 2018 to 2023,the total blood supply of“register”TDT patients was 10.37%of the total red blood supply of all medical institutions(138509.5 U/1335788.0 U),with the highest proportion of type O blood as 46.34%(64181.0 U/138509.5 U)and the lowest proportion of type AB blood as 3.85%(5331.0 U/138509.5 U).In 2018,9 transfusion medical institutions were designated for TDT patients.There were a total of 766 TDT patients in the register,with the per capita annual blood transfusion volume increased from 20.28 U(15531.0 U/766 patients)in 2018 to 36.01 U(27586.0 U/766 patients)in 2023,maintaining a positive growth every year(30.26%,4.94%,11.71%,8.61%,4.94%and 7.10%).Conclusion The"three designated"blood transfusion mode and the"collection-based-supply"blood management mode can effectively guarantee the blood supply of TDT patients.