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目的探讨实施临床用血申请管理制度对大量和超申请量用血的影响。方法设计《大量用血申请备案表》和《超申请量用血备案表》,对手术大量备血和实际用血量超过备血量的患者审核备案,并回顾性分析2012年8月-2015年7月中国医学科学院肿瘤医院大量备血和超量用血的患者数据。结果 3个年度大量备血的人次与比例分别为74(7.5‰)、58(5.3‰)、45(3.9‰),完成大量申请备案的人次与比例分别为34(46.0%)、36(62.1%)、38(84.4%),差异有统计学意义(P<0.01),但“用血备血差异度”无显著变化;超量用血的人次与比例分别为295(21.8%)、199(15.5%)、198(16.7%),完成超量用血备案的人次与比例分别为90(30.5%)、118(59.3%)、118(59.6%),差异有统计学意义(P<0.01);但需警惕的是,超量用血中大量用血的比例和“用血备血差异度”有升高趋势。结论临床用血申请管理对大量和超量用血的总体指标具有良好效果,应长期贯彻落实。
Objective To explore the impact of the implementation of clinical application of blood application management system on large amounts of blood and over the application of blood. Method Design “a large number of blood application filing form” and “over the application amount of blood record table”, a large amount of blood preparation for surgery and the actual use of blood exceeded the amount of blood prepared for the review and retrospective analysis of August 2012 -2015 In July of the Chinese Academy of Medical Sciences Cancer Hospital, a large number of patients with blood and excess blood preparation data. Results The numbers and proportions of massive blood preparation in three years were 74 (7.5 ‰), 58 (5.3 ‰) and 45 (3.9 ‰), respectively. The number and proportion of applicants who completed a large number of applications were 34 (46.0%), 36 %), 38 (84.4%), the difference was statistically significant (P <0.01), but there was no significant change in the difference of blood perfusion; the number and proportion of overdose blood were 295 (21.8% , 199 (15.5%) and 198 (16.7%) respectively. The number of patients who completed overdose of blood for medical use was 90% (30.5%), 118% (59.3%) and 118% <0.01). However, we should be alert to the fact that the proportion of large amount of blood used in excess amount of blood and the degree of difference in blood preparation have an increasing trend. Conclusion The application of clinical blood application management has good effect on the overall indicators of large amount and excess blood use, and should be implemented in long term.