A Research Of Perioperative Blood Use Status And Blood Conservation In Hebei Province

Objective: To investigate perioperative blood transfusion status and blood conservation strategies of Class-2 and Class-3 general hospitals in Hebei province,in order to improve the medical staff accordingly reasonable clinical transfusion continuing education programs for saving blood and blood conservation idea of developing accelerating the development of scientific and rational clinical use of blood.Methods: Investigate surgery and anesthesia department doctors in 37 Class-2 and Class-3 general hospitals of Hebei province by on-site survey,including 22 class-3 hospitals which have more than 6000 operations per year,and 15 class-2 hospitals which have more than 4000 operations per year.Each hospital according to the department stratified,choose at least 5 surgereons and anesthesiologists from each department,compiled “ the perioperative blood transfusion and the blood conservation questionnaire "(surgery department edition and anesthesia department edition),investigate the purpose and the basis of blood transfusion,and the blood conservation strategies.The departments including orthopedics department,obstetrics and gynecology department,general surgery department,cardiothoracic vascular surgery department,neurosurgery department,etc.Use Excel 2007 to entry and analyse data.Results:1 General: Totally 1050 questionnaires were valid questionnaires 1007 copies,of which three hospitals 695 parts,312 parts of two hospitals;257 anesthesiology,surgical departments 750 parts(of which: 197 orthopedics,obstetrics and gynecology 156,general Surgery 201 parts,101 parts of cardiothoracic Surgery,Neurosurgery 95 parts).May be implemented bedside hemoglobin or hematocrit rapid detection of a total of 31 hospitals.2 Transfusion Objective: to supplement hemoglobin,promote blood oxygen carrying capacity,for the purpose of improving coagulation total 792 physicians(78.6%),of which 228 anesthesiologists(88.7%),the surgeon 564(75.2%).3 Transfusion basis: According to the hemoglobin(Hb),blood loss,surgical cases,the patient vital signs and complications,and many other factors are taken into account anesthesiologist 182(70.8%),surgeons have 351(46.8%).Considers surgery 7g/dl < Hb ≤ 8g/dl requiring transfusion anesthesiologists have 162(63.1%),surgeons have 419(55.9%),when 8g / dl≤Hb≤9g / dl,select transfusion anesthesiologists have 21(8.2%),surgeons have 315(42.0%).That the amount of bleeding [800,1200)when ml transfusion anesthesiologists have 181(70.4%),surgeons have 513(68.4%)4 Plasma infusion by: According to anesthesiologist infusion of plasma coagulation are 200(77.8%),surgeons have 508(67.7%);in accordance with albumin infusion of plasma anesthesiologists have 60(23.3%),surgeons have 298(39.7%).5 Plasma transfusion purposes: to improve coagulation for the purpose of anesthesiologists have 215(83.7%),surgeons have 512(68.3%);to add volume for the purpose of anesthesiologists 146(56.8%),surgery there are 493 physicians(65.7%);to increase the albumin concentration for the purpose of anesthesiologists had 76(29.6%),surgeons have 265(35.5%).6 Based on platelet transfusion: platelet transfusion platelet count according to anesthesiologists have 222(86.4%),surgeons have 644(85.9%).7 Cryoprecipitate infusion by: According coagulation cryoprecipitate transfusion anesthesiologists have 219(85.2%),surgeons have 566(75.5%),according to inspection clotting factor infusion of cryoprecipitate anesthesiologists have 171(66.5%),surgeons have 479(63.9%).8 Carry autotransfusion hospitals 9.That the impact reasons for its conduct of anesthesiologists technical problems are 97(37.7%),surgeons have 373(49.7%);think the reason is to recognize the problem anesthesiologists have 156(60.7%),the surgeon 381 bit(50.8%);the reason is that the anesthesiologist costs are 177(68.9%),surgeons have 450(60.0%).Conclusions:1 Blood for clinical purpose is not clear,not strictly grasp the indications,there is still a higher proportion of empirical transfusion;component transfusion,plasma transfusion unreasonably large proportion.2 Component transfusion,infusion basis and purpose is not clear,large plasma infusion unreasonable proportions..3 Few hospitals carry autotransfusion.The cost of treatment,autologous blood transfusion techniques and clinician awareness of autologous blood transfusion is the main problem with this technique carried out in the province.