Analysis A Hospital Of Perioperative Blood Transfusion Rationality

Objective:(1) The purpose of this study is to investigate the surgical system of perioperative blood for clinical transfusion in a hospital, and to analyze the blood rationality.(2) To investigate the surgical departments of perioperative blood for clinical transfusion, and to analyze its rationality.Methods:TO Analyze surgery perioperative blood transfusion with complete data of2361cases in2010, According to the specifications of clinical blood transfusion technology make the questionnaire, Collect each of the cases of perioperative preparation blood volume, each component transfusion volume, intraoperative blood loss and the laboratory examination indexes before and after blood transfusion. Data collected by unified unit for conversion, for relevant information and data through Excel, SPSS11.00software for statistical analysis, And based on intraoperative and postoperative blood transfusion indications of rationality analysis evaluation, and analysis the reasons from unreasonable usage.Results:During the2010year, hospital surgery total number was12,216case with18surgical departments,2361cases underwent allograft composition blood transfusion, a total of2741person-time. Among them,1299person-time was transfused red blood cells, a total of727066ml;1212person-time was transfused plasma, a total of800770ml;79times was transfused platelet, a total of212250ml;151times was transfused cryoprecipitate, a total of111825ml; whole blood was transfused0times, component blood transfusion rate was100%. Intraoperative autotransfusion had73cases in surgical system, a total of38825mL, accounted for5.1%of the total red blood cell transfusion.Preoperative preparation of red blood cells, plasma, platelet and cryoprecipitate respectively was3405400mL,618300mL,133750mL,19080mL; Perioperative allogeneic red blood cell transfusion was727060ml, plasma was800770ml, platelet was212250ml, cryoprecipitate was111825ml. In18surgical departments, the ratio of red blood cells for preparation and usage from19.5to0.78; The amount of blood transfusion was1870080mL (autologous blood+allogeneic blood) in surgical system whole year, the intraoperative blood loss was2071814mL, the ratio between them was0.90:1. The transfusion volume was more than loss volume in department of Cardiac surgery, ICU, emergency department, oncology, and their ratios were3.84:1,3.04:1,1.77:1,1.53:1,1.26:1, the others ratios was form0.12to1.09. Preoperative patients Hb more than100g/L have red blood cell input has17departments, each department of blood transfusion cases accounts the total blood transfusion ratio for56.8%to100%. Preoperative patient Hb70-100g/L have red blood cell input department has14, blood transfusion cases accounted the total blood transfusion for ratio2.9%to37.8%; Preoperative Hb<70g/L have red blood cell input has11unit, blood transfusion were between0.3%and20%of the total number of each department of blood transfusion.Conclusions:(1) The hospital component blood transfusion rate was100%in2010,composition blood transfusion spread widely.(2) Preoperative erythrocyte spare capacity was greater than the actual infusion, there were "prepared" no "with" the idea, to predict and evaluate the intraoperative blood loss was not accurate enough.(3) Clinical blood transfusion indications was not strict, red blood cell, plasma reasonable use level was lower.(4) Intraoperative autotransfusion was limited in clinical departments.