Natukunda B, Schonewille H, Smit Sibinga C Th
Department of Haematology and Transfusion Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Transfus Med. 2010 Jun;20(3):134-9. doi: 10.1111/j.1365-3148.2010.00992.x. Epub 2010 Feb 1.
The aim of this study was to determine the indications for transfusion, blood ordering practices and post-transfusion complications, and to assess the clinical transfusion practice at Mbarara Regional Referral Hospital (MRRH) in Mbarara, Uganda. There are no guidelines on the appropriate use of blood at MRRH. Therefore, there was a need to assess the local clinical transfusion practice. Patients' hospital files were studied for evidence of blood transfusions in 2008. All five wards were reviewed and details on the transfusion process were recorded. A total of 1730 patients (median age, 19.0 years; range, 1 day to 88 years; female-to-male ratio, 1.4), for whom blood was cross-matched, were studied. Of these, 1674 (96.8%) patients actually received transfusions, which were as whole blood in 58.4% of recipients. The mean number of units per recipient was 1.7 and the cross-match-to-transfusion ratio was 1.3. The three most frequent indications for transfusion were malaria (38.8%), bleeding (27.1%) and other infections (16.1%). There were no records for pre-transfusion haemoglobin, compatibility testing, transfusion start-times and vital signs in 30.2, 51.8, 21.5 and 97.6% of the recipients, respectively. Transfusion reactions were recorded for 10 (0.6%) patients. Although there was no evidence of blood wastage, inadequacies were noted in the documentation of the transfusion process. There is a need to train staff in blood transfusion and to design a 'blood transfusion form' for easy monitoring and evaluation. A hospital transfusion committee and guidelines on the appropriate use of blood should be put in place at MRRH.
本研究的目的是确定输血指征、用血申请情况及输血后并发症，并评估乌干达姆巴拉拉地区转诊医院（MRRH）的临床输血实践。MRRH没有关于合理用血的指南。因此，有必要评估当地的临床输血实践。对2008年患者的医院病历进行研究，以查找输血证据。对所有五个病房进行了审查，并记录了输血过程的详细信息。共研究了1730例进行了交叉配血的患者（中位年龄19.0岁；范围1天至88岁；男女比例1.4）。其中，1674例（96.8%）患者实际接受了输血，58.4%的受血者接受的是全血。每位受血者的平均输血量为1.7单位，交叉配血与输血比例为1.3。输血的三个最常见指征是疟疾（38.8%）、出血（27.1%）和其他感染（16.1%）。分别有30.2%、51.8%、21.5%和97.6%的受血者没有输血前血红蛋白、相容性检测、输血开始时间和生命体征的记录。记录到10例（0.6%）患者发生输血反应。虽然没有血液浪费的证据，但在输血过程记录方面存在不足之处。有必要对工作人员进行输血培训，并设计一份“输血表格”以便于监测和评估。MRRH应成立医院输血委员会并制定合理用血指南。
