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[2017年至2018年四川某医院不同年龄段患者的临床用血情况]

[Clinical Blood Utilization of Patients at Different Ages for a Hospital in Sichuan from 2017 to 2018].

作者信息

Zhang Rong, Lin Jia, He Yi, Yuan Hong

机构信息

College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China.

Department of Blood Transfusion, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan Province, China.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2021 Apr;29(2):620-628. doi: 10.19746/j.cnki.issn.1009-2137.2021.02.050.

Abstract

OBJECTIVE

To analyze the use of blood products in patients at different ages.

METHODS

The clinical datas of the 10 784 patients transfused in Sichuan provincial people's hospital at 2017-2018 were retrospectively analyzed, and the basic condition of clinical blood using was statistically described. The patients were divided into the groups according to age and disease, then the use of various blood products in the patients with different diseases in different age groups was analyzed.

RESULTS

The age of blood transfusion patients was mainly 40-80 years old, and the most common disease was tumor(about 28%). The average annual transfusion volumes of red blood cells(RBC) were 24 936.5 U, of platelets(PLT) were 3 795 therapeutic doses of plasma were 2 455 500 ml, of cryoprecipitate were 3 461.5 U in our hospital. Most patients with hematologic malignancies and liver cirrhosis were transfused with two or more blood productions. For the patients with hematologic malignancies, the irradiated RBC (76.4%), PLT (67.8%), and suspended RBC (59.9%) were commonly used. And for liver cirrhosis patients, the suspended RBC (64.2%) and fresh frozen plasma(FFP) (59.4%) were commonly used. For the patients with trauma and chronic kidney disease(CKD), the suspended RBC (95.7% and 91.5%, respectively) was commonly used. In hematologic malignancies patients, the transfusion volume of irradiated RBC, PLT and FFP in the patients aged ≥60 years old was lower than that in patients aged<60 years old (P<0.05); in trauma patients, the transfusion volume of suspended RBC in the patients aged ≥60 years old was lower than that in patients aged<60 years old (P<0.05). In hematologic malignancies, trauma and liver cirrhosis patients, the proportion of PLT and/or plasma transfusion in the patients aged ≥60 years old was lower than that in patients aged<60 years old (P<0.05), and the elderly patients were more likely to receive RBC transfusion only.

CONCLUSION

There is a difference in the distribution of blood product between the patients aged<60 years old and ≥60 years old in the same disease, and it is more likely that the elderly patients (aged ≥60 years old) receive RBC transfusion only, and correction of hypoxia is a major clinical consideration, so blood using plans should be made according to the patient population, moreover, the different transfusion strategies should be developed for different population to maximize the efficiency of blood using.

摘要

目的

分析不同年龄段患者血液制品的使用情况。

方法

回顾性分析2017 - 2018年在四川省人民医院输血的10784例患者的临床资料,对临床用血基本情况进行统计描述。根据年龄和疾病将患者分组,分析不同年龄组不同疾病患者各类血液制品的使用情况。

结果

输血患者年龄主要集中在40 - 80岁,最常见疾病为肿瘤(约28%)。我院红细胞(RBC)年平均输血量为24936.5U,血小板(PLT)为3795治疗量,血浆为2455500ml,冷沉淀为3461.5U。大多数血液系统恶性肿瘤和肝硬化患者输注两种或更多血液制品。血液系统恶性肿瘤患者常用辐照红细胞(76.4%)、血小板(67.8%)和悬浮红细胞(59.9%)。肝硬化患者常用悬浮红细胞(64.2%)和新鲜冰冻血浆(FFP)(59.4%)。创伤和慢性肾脏病(CKD)患者常用悬浮红细胞(分别为95.7%和91.5%)。血液系统恶性肿瘤患者中,≥60岁患者的辐照红细胞、血小板和FFP输血量低于<60岁患者(P<0.05);创伤患者中,≥60岁患者的悬浮红细胞输血量低于<60岁患者(P<0.05)。在血液系统恶性肿瘤、创伤和肝硬化患者中,≥60岁患者血小板和/或血浆输注比例低于<60岁患者(P<0.05),老年患者更倾向于仅接受红细胞输血。

结论

同一种疾病中,<60岁和≥60岁患者血液制品使用分布存在差异,老年患者(≥60岁)更倾向于仅接受红细胞输血,纠正缺氧是主要临床考量,应根据患者群体制定用血计划,此外,应为不同人群制定不同输血策略以最大化用血效率。

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