Kohn M R, Rowlings P A, Ham J M
Department of Surgery, Prince of Wales Hospital, Randwick, New South Wales, Australia.
Aust N Z J Surg. 1990 May;60(5):351-4. doi: 10.1111/j.1445-2197.1990.tb07383.x.
The blood ordering practices for acute upper gastrointestinal bleeding were assessed in 162 consecutive patients presenting with haematemesis admitted via the Accident and Emergency Centre. The patients were classified according to their estimated blood loss and haemoglobin level at the time of admission, and the amounts of blood ordered and given in the next 24 h were determined. The crossmatch: transfusion (CT) ratio was very high in one group (14.9), although the overall ratio of 2.4 was acceptable. There were marked variations in the ordering pattern of different medical officers, possibly because of the absence of clear guidelines. From the data obtained, a set of guidelines for ordering blood in this clinical condition was developed. It was estimated that if these guidelines had been used, there would have been a reduction of one-third of all units crossmatched, and that the overall CT ratio would have been reduced to 1.6.
对通过急诊中心收治的162例连续出现呕血症状的急性上消化道出血患者的用血情况进行了评估。根据患者入院时估计的失血量和血红蛋白水平进行分类，并确定接下来24小时内的用血申请量和输血量。其中一组的交叉配血：输血（CT）比例非常高（14.9），尽管总体比例2.4是可以接受的。不同医生的用血申请模式存在显著差异，可能是因为缺乏明确的指导原则。根据所获得的数据，制定了一套针对这种临床情况的用血指导原则。据估计，如果采用这些指导原则，交叉配血的单位总量将减少三分之一，总体CT比例将降至1.6。
