摘要
目的回顾分析中山大学附属第七医院临床输血质量控制情况,为同类医院的输血科建设和临床输血管理提供参考。方法收集中山大学附属第七医院2018年5月-2022年9月的临床用血量、临床用血质量控制指标,按照中山大学附属第七医院实现全面质量控制指标监测管理的时间,以2020年12月前为监测前,统计分析建院以来或监测前后输血检验质量管理情况、临床用血管理情况、血液使用情况的变化。结果输血相容性检测项目室内质控率从80%提高到100%;输血相容性检测室间质评项目参加率由60%提高到100%;室间质评项目合格率一直保持100%;出院患者人均用血量从(0.29±0.1)U降至(0.23±0.03)U,差异具有统计学意义(t=2.5,P<0.05);一二级手术台均用血量最多时仅为0.01 U;三四级手术台均用血量从(0.11±0.07)U降至(0.08±0.04)U,差异具有统计学意义(t=2.1,P<0.05);血浆与红细胞比值降低至0.61;《临床输血申请单》合格率保持>98%并仍不断提高,监测前组、监测后组差异具有统计学意义(χ^(2)=26.965,P<0.01);受血者标本血型复查率一直保持100%;千输血人次输血不良反应上报例数从(6.673±0.083)例上升到(12.060±0.00)例;手术患者自体输血率由3.6%提高到12.7%,差异具有统计学意义(χ^(2)=59.747,P<0.01)。结论中山大学附属第七医院在创建三甲医院过程中,开业即实施了较好的临床输血质量管理,并通过临床用血质量控制指标监测实现有效提高;但仍存在自体输血率低等薄弱环节需加快建设。
Objective To retrospectively analyze the quality control of clinical blood transfusion in the Seventh Affiliated Hospital,Sun Yat-sen University and provide references for the construction of blood transfusion departments and clinical blood management in similar hospitals.Methods Clinical blood consumption and quality control indicators were collectedfrom May 2018 to September 2022.The hospital achieved comprehensive quality control index monitoring management in December 2020.The effects of transfusion test quality management,clinical blood use management and blood use before and after the implementation of comprehensive quality control index monitoring management were systematically analyzed.Results The internal quality control rate of blood transfusion compatibility testing increased from 80%to 100%.The participation rate of external quality assessment for compatibility testing in the transfusion department increased from 60%to 100%.The pass rate of external quality assessment for compatibility testing in the department was maintained at 100%.The average blood consumption per discharged patient decreased from(0.29±0.1)U to(0.23±0.03)U,with a statistically significant difference(t=2.5,P<0.05).The blood consumption per operating table for grade I and II surgeries was only 0.01 U;the blood consumption per operating table for grade III and IV surgeries decreased from(0.11±0.07)U to(0.08±0.04)U,with a statistically significant difference(t=2.1,P<0.05).The plasma to red blood cell ratio decreased to 0.61.The pass rate of Clinical Blood Transfusion Application Form remained>98%and continued to improve,with a statistically significant difference between the pre and post groups(χ^(2)=26.965,P<0.01).The blood group reexamination rate of the blood specimens was 100%.The number of reported cases of adverse blood transfusion reactions per thousand blood transfusion patients increased from(6.673±0.083)to(12.060±0.000).The autotransfusion rate in surgical patients increased from 3.6%to 12.7%,with a statistically significant difference(χ^(2)=59.747,P<0.01).Conclusion During the establishment of the tertiary hospital,the Seventh Affiliated Hospital of Sun Yat-sen University implemented effective clinical transfusion quality management and made improvements by monitoring the clinical blood quality control indicators.However,the rate of autotransfusion still needs to be increased.
作者
彭燕华
高婧
钟燕玲
PENG Yanhua;GAO Jing;ZHONG Yanling(The Seventh Affiliated Hospital,Sun Yat-sen University,Shenzhen 518107,China)
出处
《现代医院》
2023年第8期1211-1215,共5页
Modern Hospitals
关键词
临床用血
质量控制
输血科建设
输血管理
临床用血质量控制指标
质量管理
Clinical blood use
Quality control
Construction of blood transfusion department
Clinical blood use management
Clinical blood quality control index
Quality management
