Kamani A A, McMorland G H, Wadsworth L D
Division of Obstetric Anaesthesia, Grace Hospital, Vancouver, British Columbia, Canada.
Am J Obstet Gynecol. 1988 Nov;159(5):1177-81. doi: 10.1016/0002-9378(88)90440-1.
The transfusion experience for a 1-year period (September 1985 to August 1986) at a tertiary referral obstetric hospital was reviewed retrospectively. During the review period 7731 mothers were delivered and 6003 patients (83%) underwent type-and-screen procedures. A total of 1057 units of red blood cells were crossmatched, and 362 of these 1057 units were transfused to 100 parturient women so that the overall crossmatch/transfusion ratio was 2.9:1. Five percent of transfused patients received 1 unit; 52% of patients received 2 units, 19% received 3 units and 24% received greater than or equal to 4 units of packed red blood cells. Major indications for transfusion were uterine atony, 27%; retained placenta, 17%; trauma, 17%, placenta previa, 7%; and abruptio placentae, 5%. In 12% of patients transfusions were done because of anemia. This study shows the value of audit and confirms that the type-and-screen procedure is an effective way of reducing the crossmatch/transfusion ratio without compromising patient care, even in high-risk patients.
对一家三级转诊产科医院1年期间（1985年9月至1986年8月）的输血情况进行了回顾性研究。在回顾期间，共分娩7731名产妇，6003例患者（83%）接受了血型鉴定和筛查。共交叉配血1057单位红细胞，其中362单位输给了100名产妇，因此交叉配血/输血总体比例为2.9:1。5%的输血患者接受1单位；52%的患者接受2单位，19%接受3单位，24%接受≥4单位浓缩红细胞。输血的主要指征为宫缩乏力，占27%；胎盘残留，占17%；创伤，占17%；前置胎盘，占7%；胎盘早剥，占5%。12%的患者因贫血进行输血。本研究显示了审核的价值，并证实血型鉴定和筛查程序是降低交叉配血/输血比例的有效方法，即使在高危患者中也不会影响患者护理。
