Application of single disease in Standardization of blood ordering in elective surgery
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摘要: 目的:根据单病种患者术中红细胞使用量,制定相应病种手术备血方案。方法:收集本市3家三甲级医院接受髋关节置换术、腰椎管狭窄减压术、子宫切除术、二尖瓣置换成形术这4种择期手术患者术前备血和实际术中输血量,用统计学软件进行分析,比较不同手术实际输血率。结果:4种手术备血量、备血人数明显多于实际输血量和输血人数。髋关节置换术T%和n%分别为2.3%、2.4%、输血备血差异度为-0.98,腰椎管狭窄减压术T%和n%分别为53.7%、65.3%,输血备血差异度为-0.46,子宫切除术分别为5.0%、2.9%、-0.95,二尖瓣置换术分别为26.8%、35.3%、-0.73。结论:外科手术备血应根据实际手术部位,手术方式,实际输血量和输血人数进行循证研究,建立择期手术患者备血策略,单病种在择期手术患者备血策略中可以提供指导性意见,推动节约用血和合理用血的有效实施。Abstract: Objective:To analyze the amount of RBC used in the operation in the single disease in order to make a strategy for blood ordering.Method:The data of the amount of blood ordering and the actual blood usage intro-operation were collected and analyzed in the patients with the hip replacement,the decompression for lumbar spinal stenosis,the hysterectomy and the mitral valve surgery from 3 tertiary hospitals.Result:The amount of blood ordering and the amount of the planned transfusion patients were more than the actual blood usage and the actual transfusion patients.T%,n% and the difference between ordering units and transfusion units of the four operations were2.3%,2.4%,-0.98(the hip replacement),53.7%,65.3%,-0.46(the decompression for lumbar spinal stenosis),5.0%,2.9%,-0.95(the hysterectomy),and 26.8%,35.3%,-0.73(the mitral valve surgery),respectively.Conclusion:The surgical blood ordering schedule is proposed according to the site of operation,the surgery way,the actual blood usage and the actual requirements of patients.It has been confirmed that the single disease can provide the guidance opinion to the surgical blood ordering schedule in order to save blood and reasonable usage.
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Key words:
- single disease /
- blood ordering /
- surgical blood ordering schedule
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[1] Subramanian A,Sagar S,Kumar S,et al.Maximum surgical blood ordering schedule in a tertiary trauma center in northern India:A proposal[J].J Emerg Trauma Shock,2012,5:321-327.
[2] 彭涛,徐立伟,刘敏,等.大量和超申请量用血3年管理的效果分析[J].中国输血杂志,2016,29(1):100-102.
[3] 李喜莹,赵国华,刘敏,等.肿瘤患者手术备血策略的建立及其手术用血影响因素分析[J].中华医学杂志,2013,93(32):2562-2566.
[4] Hall TC,Pattenden C,Hollobone C,et al.Blood Transfusion Policies in Elective General Surgery:How to Optimise Cross-Match-to-Transfusion Ratios[J].Transfus Med Hemother,2013,40:27-31.
[5] 江艇,陈守梅.某院外科手术备血和术中用血分析[J].中国输血杂志,2017,30(8):914-916.
[6] 孙波,刘术臻,张少强,等.限制性发血在择期手术输血患者中的应用[J].中国输血杂志,2015,5(28):556-558.
[7] White MJ,Hazard SW,Frank SM,et al.The evolutionof perioperative transfusion testing and blood ordering[J].Anesth Analg,2015,120:1196-1203.
[8] Cheng DR,Bajraszewski C,Verma KP,et al.How appropriately is blood ordered in a rural hospital?[J].Transfus Apher Sci,2013,48:79-82.
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