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临床输血与检验

临床输血与检验 ›› 2016, Vol. 18 ›› Issue (6): 528-531.DOI: 10.3969/j.issn.1671-2587.2016.06.005

• 临床输血 • 上一篇    下一篇

ICU住院患者临床输血调查*

李红梅,王远杰   

  1. 629000 四川省遂宁市中心医院输血科
  • 收稿日期:2016-07-20 出版日期:2016-12-20 发布日期:2016-12-23
  • 通讯作者: 王远杰,男,主任技师,主要从事临床输血研究,（Tel）0825-2292484,（E-mail） scsnwyj@126.com。
  • 作者简介:李红梅（1970-）,女,四川遂宁人,副主任技师,主要从事临床输血研究工作,（Tel）15982500563（E-mail）li-dan-mei@163.com。
  • 基金资助:
    *本课题受四川省卫生厅项目（No.120023）、四川省科技厅科技支撑计划（No.2014SZ0033）资助

An Investigation of Clinical Blood Transfusion in ICU Patients

LI hong-mei, WANG Yuan-jie   

  1. Suining City Central Hospital Transfusion Sichuan Suining 629000
  • Received:2016-07-20 Online:2016-12-20 Published:2016-12-23

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摘要： 目的了解本院ICU患者血液成分的输注情况、输注量、合理性以及转归（好转、恶化、死亡）。方法回顾性调查2015年6~12月本院274例接受血液成分输注的ICU患者病历资料 ,对输血情况、输血指征、实验室检测、疗效进行统计分析。结果①274例重症输血患者中,91.2%（250／274）、87.2%（239/274）、2.6%（7／274）、5.8%（16／274）分别输注了红细胞、 血浆、冷沉淀、血小板。红细胞输注量以心胸外科 、消化道出血、产后大出血居多,占输红细胞患者的61.2 %（153/250）。Hb>100 g/L和Hb在70~100 g/L的红细胞输注率分别为15.3%（42/274）、29.5%（81/274）,Hb<70 g/L输注红细胞的仅占输血患者的46.4%（127/274）,红细胞输注不够合理。②进入ICU时,89.1%（213/239）的患者PT、APTT、Fib结果低于正常,PLT值均< 50×109/L,血浆、血小板和冷沉淀输注基本合理。③随着住院时间的延长,患者红细胞输注量随之增加,患者的病死率与患者输血量无明显关系。结论ICU患者大多以血液成分联合输注为主,以输注2种血液成分的居多,血浆输注基本合理,冷沉淀及血小板输注合理,红细胞输注合理性有待提高。患者的输血量与病死率无明显关系,与ICU住院和住院总时间有关。患者的预后与本身所患疾病和并发症等多种因素有关。

关键词: 重症患者, 血液成分输注, 输血指征, 转归, 合理性

Abstract: ObjectiveTo understand the status of blood component transfusion,infusion volume,rationality and outcomes in the ICU patients. MethodsRetrospective investigation from June to December 2015 was executed in 274 ICU patients who had underwent blood component transfusion,whole blood transfusion and transfusion indications.Laboratory tests and curative effect were analyzed. ResultsOf 274 cases of severe patients with blood transfusions,91.2%（250/274）,87.2%（239/274）,2.6%（7/274）,and 5.8%（16/274） of them received infusion of red blood cells,plasma,cryo,and platelets. The biggest red blood cell transfusion volume was seen in the patients of thoracic surgery,gastrointestinal bleeding,postpartum hemorrhage,accounting for 61.2%（153/250）. 15.3 percent（42/274）and 29.5% （84/274）of patients had RBC transfusion whose Hb was over100 g/L and Hb was between 70~100 g/L,Patients with Hb<of 70 g/L had RBC transfusion rate of 46.4%（127/274）89.1 percent（213/239）of ICU patients presented low PT,APTT and Fib,with an average value of <50×109/L and a rational use of plasma,platelets and cryo. The volume of RBC transfusion was gradually increased with the duration of hospitalization,and no significant association of mortality with the volume of RBC use was noted. ConclusionIn ICU patients,combination of two blood components were frequently used,and the rationality was seen in transfusions of plasma,cryo,and platelets rather than in red blood cells.

Key words: Severe, patients, Blood, component, transfusion, Evidence, of, blood, transfusion, The, outcome

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