CAJ | 학술논문

目的：浅析手术患者合理用血质量管理取得的成效，进一步减少不合理输注的发生．方法：回顾湖南省脑科医院和长沙市中心医院2011／2014手术患者临床用血情况，利用信息系统统计外科患者的手术台次、输血手术台次、术中异体输血量、自体输血量、大量输血例数及用血量等指标，使用SPSS17．0统计软件对相关数据进行分析．结果：近四年间两家医院手术台次逐年递增，2014年较2011年增长了28．77％，而异体输血手术台次却下降了9．8％；同期血液制品总输注率、异体输血手术台次及其所占比率、异体红细胞、血浆用血量，手术台均异体红细胞、血浆用量及血浆与红细胞用量比均呈负增长趋势；术中自体输血率呈明显增长趋势；同期大量用血例数呈明显下降趋势．2014年较2011年下降了73．9％．红细胞输注率、血浆输注率、大量用血例均红细胞用量、例均血浆用量等均呈明显下降趋势．结论：规范化管理标准的制定?学习、沟通?督查和反馈的循环过程是输血科变被动为主动的过程，是一个为临床医生所认可的过程，特别是输血科参与特殊输血病例的会诊，为每一个危急重病人量身定做输血方案，同时加强对临床医护人员科学、合理用血及输血相关法律法规的培训，使得医院临床用血质量管理体系和术中用血质量管理可持续改进运行，成效显著，有效地减少了不合理输注现象的发生．
목적：천석수술환자합리용혈질량관리취득적성효，진일보감소불합리수주적발생．방법：회고호남성뇌과의원화장사시중심의원2011／2014수술환자림상용혈정황，이용신식계통통계외과환자적수술태차、수혈수술태차、술중이체수혈량、자체수혈량、대량수혈례수급용혈량등지표，사용SPSS17．0통계연건대상관수거진행분석．결과：근사년간량가의원수술태차축년체증，2014년교2011년증장료28．77％，이이체수혈수술태차각하강료9．8％；동기혈액제품총수주솔、이체수혈수술태차급기소점비솔、이체홍세포、혈장용혈량，수술태균이체홍세포、혈장용량급혈장여홍세포용량비균정부증장추세；술중자체수혈솔정명현증장추세；동기대량용혈례수정명현하강추세．2014년교2011년하강료73．9％．홍세포수주솔、혈장수주솔、대량용혈례균홍세포용량、례균혈장용량등균정명현하강추세．결론：규범화관리표준적제정?학습、구통?독사화반궤적순배과정시수혈과변피동위주동적과정，시일개위림상의생소인가적과정，특별시수혈과삼여특수수혈병례적회진，위매일개위급중병인량신정주수혈방안，동시가강대림상의호인원과학、합리용혈급수혈상관법율법규적배훈，사득의원림상용혈질량관리체계화술중용혈질량관리가지속개진운행，성효현저，유효지감소료불합리수주현상적발생．
AIM: To analyze the effectiveness of quality man?agement on rational blood transfusion for surgical patients and to further reduce unreasonable infusion. METHODS: The clinical data of blood transfusion of surgical patients in the Second People?s Hospital of Hunan province and Changsha Central Hospi?tal from 2011 to 2014 were retrospectively analysed, then by using statistics information system, indicators of surgical patients such as numbers of operation, numbers of transfusion, the total amount of intra?operative allogeneic transfusion and autologous transfu?sion, the number of cases and total amount of massive transfusion were collected and analyzed by SPSS17.0 statistical software. RE?SULTS:In the past nearly four years, the numbers of surgery in both hospitals have increased year by year. In 2014, the numbers of operations increased by 28.77% over 2011, but the numbers of operation with allogeneic blood transfusion declined by 9.8%. O?ver the same period, the total rate of blood products transfusion, the ratio of the numbers of allogeneic blood transfusion, the total usage of erythrocyte and plasma, the average amount of allogeneic red blood cells and plasma and the total usage of plasma and e?rythrocyte during the operations showed a negative trend. The rate of autologous transfusion during surgery was on the rise. The num?ber of massive blood transfusion cases decreased significantly over the same period. More specifically, it was decreased by 73.9% in 2014 compared to 2011. The transfusion rate of red blood cell and, plasma infusion rate, the average amount of the most red blood cells and plasma significantly decreased. CONCLUSION:The cyclic processes which involve the establishment of standard?ized management standard that build normative management standard?learn and communication?inspection and feedback, transform passive management into initiative one for Blood Trans?fusion Department and were recognized by clinicians. Especially, the participation in the consultation about special cases of blood transfusion by department of blood transfusion, and the tailored transfusion protocol for each critical ill patients, strengthening the training of scientific and reasonable blood utilization and transfu?sion related laws and regulations in transfusion among the clinical medical staff, continuous improvement of quality management in clinical blood and intra?operative blood transfusion have made re?markable achievements, and these measures could reduce the in?cidence of unreasonable transfusion practice.