[医院对新鲜冰冻血浆的使用情况]

Barbolla L, Richart A, Paniagua C

Servicio de Hematología y Hemoterapia, Fundación Jiménez Díaz, U.A.M., Madrid.

Sangre (Barc). 1997 Oct;42(5):351-6.

PURPOSE

The aim of this work is double. On the one hand, to assess if the measures to strictly control the clinical indications of fresh-frozen plasma (FFP) transfusion may lead to a decrease of its use, and on the other to assess the importance of FFP with regard to other blood components, along with disclosing the number and characteristics of the more patients and those who receive only FFP.

MATERIAL AND METHODS

Starting from data of the blood bank and the hospital records, an analysis of the use of FFP in the General Hospital was carried out, and it was correlated with the use of other blood components, mostly red cells (RC), and the hospital indices expressed as DRG. An analysis was also performed of the use of FFP in 1996 with regard to the number of transfused patients, mean consumed units in general and according to patient-groups, association with RC use and identification of high-use patients (defined as requiring over 3 FFP units).

RESULTS

A decrease in the use of FFP between 1992 and 1996 was appreciated, from 1,385 to 760 units. This decrease, when correlated with the use of RC, was from 17.8 to 9.2 FFP units/ 100 RC units during this period. The FFP units/100 RC units varied from 6 to 2 in three years; this index has been stable since then. With regard to the use in 1996, 162 patients received FFP, which represents 4% of all the transfusions in the hospital. Of these, 15 patients received only plasma (9% of the patients receiving FFP and 0.3% of all transfusions). Other blood components, mainly RC, were associated to FFP in 96% of the cases. The patients consuming more FFP units were those of heart surgery and intensive care units, with significant differences with respect to others.

CONCLUSIONS

This study shows a steady decrease in the use of FFP, which is stable in the last years. The patients receiving only FFP represented a low number with respect to all the patients transfused. The follow-up of these patients might provide valuable data about the benefit of adding additional security processes to standard FFP.

目的

本研究有双重目的。一方面，评估严格控制新鲜冰冻血浆（FFP）输血临床指征的措施是否会导致其使用量减少；另一方面，评估FFP相对于其他血液成分的重要性，同时披露接受FFP的患者数量、特征以及仅接受FFP的患者情况。

材料与方法

从血库数据和医院记录入手，对综合医院FFP的使用情况进行分析，并将其与其他血液成分（主要是红细胞（RC））的使用情况以及以疾病诊断相关分组（DRG）表示的医院指标相关联。还对1996年FFP的使用情况进行了分析，涉及输血患者数量、总体平均使用单位数以及按患者群体划分的使用情况、与RC使用的关联以及高使用量患者（定义为需要超过3个FFP单位）的识别。

结果

1992年至1996年期间，FFP的使用量有所下降，从1385单位降至760单位。与RC的使用情况相关联时，这一期间FFP单位/100个RC单位的比例从17.8降至9.2。三年间FFP单位/100个RC单位的比例从6降至2；此后该指标一直稳定。关于1996年的使用情况，162名患者接受了FFP，占医院所有输血患者的4%。其中，15名患者仅接受血浆（占接受FFP患者的9%，占所有输血患者的0.3%）。在96%的病例中，其他血液成分（主要是RC）与FFP同时使用。使用FFP单位较多的患者是心脏手术患者和重症监护病房患者，与其他患者存在显著差异。