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【Objective】 To establish a comprehensive performance appraisal system, in order to promote blood collection, preparation and supply. 【Methods】 The performance reform leading group headed by the central leader was set up to manage the overall work, with performance reform office set up to formulate the central performance reform plan and the target assessment plan. The operation effectiveness was evaluated by comparing the index changes in blood collection, preparation and supply. 【Results】 Compared with before the implementation of performance (from 2018 to 2019, a total of 24 months), except for the total monthly collection of street whole blood, the per person of street monthly blood collection and the total and per person monthly collection of apheresis platelets were significantly increased (P<0.05) during the process of blood collection. The total and per person monthly preparation of cryoprecipitates and virus inactivates plasma were significantly increased (P<0.05) during the process of blood preparation. The total and per person monthly supply of apheresis platelets, cryoprecipitates and virus inactivates plasma were significantly increased (P<0.05) during the process of blood supply. 【Conclusion】 The adjustment and implementation of performance reform program optimized the performance salary distribution system, and the formulation and implementation of target assessment program significantly promoted blood collection, preparation and supply.
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【Objective】 To explore the corresponding strategies of blood preparation for placenta previa operation in our hospital according to the situation of blood transfusion during and after operation. 【Methods】 Ninety pregnant women with placenta previa (complete, partial or marginal) undergoing the caesarean operation and blood transfusion in our hospital from January 2011 to September 2020 were selected as the research objects. The corresponding data about intraoperative/postoperative blood loss, blood transfusion and blood preparation were collected, analyzed and compared. 【Results】 There was no significant differences in age between complete and marginal placenta previa(P>0.05), but significant differences in intraoperative/postoperative blood loss and the units of blood transfusion (P1 000 mL). The difference between ordering and transfusion units of complete and marginal placenta previa were 0.4 and 0, respectively. When the complete placenta previa was accompanied by placenta increta or placenta percreta, the blood loss was larger (>1 000 mL) and the units of blood transfusion ranged from 4.5 U to 6 U, while the blood loss was generally low (≤1 000 mL) and the units of blood transfusion was concentrated at 3 (2, 4) U without placenta accreta nor implantation.The difference between ordering and transfusion units of complete placenta previa with non-implantation, placenta accreta, placenta increta and placenta percreta were 0.165, 0.33, 0.5 and 1, respectively. 【Conclusion】 For marginal placenta previa, 3U blood is recommended for routine preparation, 3U blood for complete placenta previa with non-implantation or placenta accrete, and 4.5-6U for complete placenta previa with placenta increta or placenta percreta.
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【Objective】 To retrospectively analyze the clinical use of low-dose blood components in Dongguan and the trend of clinical pediatric blood use, so as to provide reference for better preparation and inventory management of low-dose blood components in blood centers. 【Methods】 The clinical consumption of RBCs, platelets and plasma of Dongguan Blood Center from 2015 to 2020 was counted. The compositions and changes of low-dose blood components by specifications (0.25 U, 0.5 U), years and hospitals (public grade A general hospital, public grade A specialized hospital, private grade A hospital, private hospital equivalent to grade A, regional central hospital, public township hospital, small private hospital) were analyzed. 【Results】 The cumulative growth rates of low-dose RBCs, platelets, and plasma in 6 years were 10.78%, 1 098.55% and -29.41%, respectively, and the compound annual growth rates were 2.07%, 64.34% and -6.73%, respectively. The composition of low-dose blood components in RBCs, platelets and plasma was different (P<0.05) in different levels of hospitals, among which RBCs and plasma were the mostly used in public grade A specialized hospital, accounting for 45.08% (7 272 /16 133) and 53.18% (7 199/13 373) respectively, while platelets were the mostly used in private grade A management hospitals, accounting for 77.38% (3 393/4 385), dominated by apheresis platelets 53.84% (1 144/2 125) and irradiated apheresis platelets 99.51% (2 249/2 260). The composition ratios of 0.25 U and 0.5 U RBCs used in different hospitals were significantly different (P<0.05). The 0.25 U RBCs were used mostly in public grade A hospitals (62.60%, 3 502/5 594) and 0.5 U RBCs in public grade A specialized hospitals (62.09%, 6 544/10 539). 【Conclusion】 The total consumption of low-dose blood components in clinical pediatrics from 2015 to 2020 were as follows: platelets had increased significantly year by year, RBCs had increased steadily and with fluctuation, plasma had a downward trend year by year. The consumption volume and varieties used in different levels of hospitals were uneven, which may be related to the development of pediatrics departments in hospitals and their capabilities to conduct new business. Regular monitoring of the trend of low-dose blood component consumption is of great significance to guarantee the pediatric clinical blood supply.
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【Objective】 To investigate the influence of different packaging methods on the volume of low-dose(0.5 U) suspended leucocyte depleted red blood cells(SLD RBC) and provide reference for accurate labeling. 【Methods】 Bags of SLD RBC in 1.5 U and 2 U were randomly sampled to measure the weight and specific gravity of each bag, so as to estimate the blood volume.The relationship between the weight and volume of 0.5 U blood, split from different parent bags, was analyzed and the linear regression equation was put forward.The regression equation was used to calculate and analyze the difference in the volume of 0.5 U SLD RBC prepared by three different packaging methods (A: manual multi-bag average packing; B: instrument multi-bag average packing; C: manual single-bag packing) in actual work. 【Results】 The specific gravity of 1.5 U (38 bags) and 2 U SLD RBC (39 bags) were (1.090±0.011) g/mL and (1.097±0.013) g/mL, respectively, and the difference was statistically significant (P<0.05). After the 0.5 U subsidiary bags were split from the parent bags(1.5 U or 2 U), the regression equations for the volume (Y) of 0.5 U and gross weight (X) of the whole bag were respectively: Y1.5 U packing=0.902 7X-12.52 (P<0.05) and Y2 U packing=0.905 6X-13.15(P<0.05). In actual blood packaging, the average blood volume of 0.5 U subsidiary bags split from 1.5 U bag, using method A and B, were smaller than those split from 2 U bag [(62.12±5.38) mL and (62.50±6.77) mL vs (67.72±3.81) mL and(68.39±6.44)mL] (P<0.05), with the deviation of low-dose blood volume from 5.593 mL to 5.887 mL.The volume deviation by method B (10.84% and 9.42%) were greater than that by method A (8.67% and 5.63%). The average volume of 0.5 U subsidiary bags split from 1.5 U and 2 U by method C were (65.49±1.72) mL and (64.99±1.91) mL (P>0.05), with volume deviation at 2.63% and 2.94%, respectively.The mean volume value of overall 0.5 U blood (n=483) was (65.35±5.34) mL. 【Conclusion】 For packaging 0.5 U subsidiary bags, the instrument multi-bag packaging showed the largest volume deviation, followed by the manual multi-bag packaging and the single-bag packaging.The volume labeling of low-dose SLD RBC should be established, according to the specifications of parent bags and specific gravity.
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【Objective】 To provide reference for formulating preoperative blood preparation plan for malignant osteosarcoma scientifically and rationally under the persistent COVID-19 epidemic by studying the high-risk influencing factors related to intraoperative blood transfusion in patients with primary malignant osteosarcoma. 【Methods】 The general data, preoperative blood routine and coagulation parameter, clinicopathological record and surgical data of 120 patients with primary malignant osteosarcoma in Beijing Jishuitan Hospital from January 2020 to January 2021 were retrospectively analyzed by univariate analysis, multivariate regression analysis and Pearson correlation analysis to determine the high risk factors for intraoperative blood transfusion in patients with primary malignant osteosarcoma. 【Results】 The incidence of intraoperative and postoperative blood transfusion of malignant osteosarcoma patients were 48.33% (58/120) and 62.50% (75/120), with the average blood transfusion units at (1.36±1.14) U and (2.93±2.26) U, respectively. The univariate analysis showed that such factors as sex, preoperative Hct (%), preoperative Plt (×109/L), location of lesion, Huvos classification, incision length (cm), reconstruction length(cm) and intraoperative blood loss (mL) were significantly different (P<0.05). Multivariate logistic regression analysis showed that sex, location of lesion, Huvos classification, incision length (cm), reconstruction length(cm) and intraoperative blood loss (mL) were significantly different (P<0.05). 【Conclusion】 For primary malignant osteosarcoma with a high rate of intraoperative blood transfusion, early intervention should be carried out according to the high-risk factors of intraoperative blood transfusion, and preoperative blood preparation plan should be accurately formulated to effectively reduce the rate and units of blood transfusion in patients under the premise of surgery safety.
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【Objective】 To analyze the factors affecting "one-time yield" in blood plasma separation (BPS) and explore the methods to improve the rate of it. 【Methods】 The rate of "one-time yield" in BPS of 2018 was calculated and the influencing factors were analyzed. Such influencing factors as air release after leukodepletion, poor performance of leukodepletion filter, selection of blood bag barrel, cup filling method, standing time after centrifugation, separation method were improved in 2019, and the difference of the "one-time plasma yield" rate of fresh frozen plasma/frozen plasma and the centrifugal damage before and after the improvement were compared. 【Results】 After the improvement, the rate of "one-time yield" of fresh frozen and frozen plasma increased to 89% and 80%, respectively, which was significantly increased as compared with that before(P<0.05); the centrifugal damage rate decreased to 0.01%, showed no statistical significance compared with that before. 【Conclusion】 With accurate analysis of the factors affecting "one-time plasma yield", the improved method proved to be effective, the rate of "one-time yield" has been improved significantly, and the blood quality has been guaranteed.
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【Objective】 To explore the feasibility and necessity of establishing a scheduled blood donation team focusing on pregnant women′s blood preparation by the comparative analysis between RhD positive and negative pregnant women′s family participation in the team, so as to provide basis for decision-making on fine management of key groups of voluntary blood donation. 【Methods】 A questionnaire survey was conducted between the families of RhD negative and positive pregnant women participating in the blood preparation program from January to September 2020 to compare the differences in incentive measures, blood donation cognition, motivation, intention and behavior between the two groups. 【Results】 For common incentive measures for blood donation, both families of RhD negative pregnant women(the former) and families of RhD positive pregnant women(the latter) preferred expectant mothers to use blood first, accounting for 98.02% (99/101) and 98.51% (132/134), respectively, with no significant difference.For other incentive measures, the preference of the former were significantly higher (P<0.05). For the cognition of voluntary blood donation, the awareness of the former was higher than that of the latter, with significant difference(P<0.05), except for clinical blood use expenses; the score of intention to donate blood of the former was higher than that of the latter(P<0.05); among the six factors of motivation to blood donation, the score of severity of the former(understanding of the status of blood supply) was higher than that of the latter, and the difference was statistically significant(P<0.05). Analysis of ROC curve showed that AUC of fitting model of the former and latter was 0.816 (95% CI: 0.731~0.902) and 0.924 (95% CI: 0.871~0.977). 【Conclusion】 Pregnant women families participated in the program are more interested in the incentive measures of health policies.The former has higher awareness of the current supply situation hence demonstrates higher intention to donate blood than the latter.Therefore, relevant policies should be formulated to improve the enthusiasm of pregnant women families to participate in voluntary blood donation, optimize the construction strategy of scheduled blood donation team and expand the donation team while ensuring blood use of pregnant women.
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【Objective】 To observe the application of the traditional and modified catheter transfer method in leukocyte-depleted blood preparation and the effect of modified method on reducing the blood discard rate due to hot joint leakage. 【Methods】 After leucocyte filtration, the traditional method is to seal the product bag catheter directly and then connect the whole blood catheter, while the modified method is to seal the two sections on the product bag catheter and then connect the whole blood catheter at the distal seal. The blood discard rates of the two methods due to the hot joint leakage in the catheter connection of leukocyte reduction were analyzed. 【Results】 After repeated training for the staff, using the same type of equipment, the blood discard rate due to heat sealing leakage by modified method was 0(0/33 595), significantly lower than that by traditional method(0.11%, 36/32 873, P<0.001). 【Conclusion】 The modified method can significantly reduce the discard rate of blood due to seal leakage and save valuable blood resources. However, there is still a risk of seal leakage, and staff should take preventive measures against occupational exposure
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Objective To evaluate the perioperative blood loss and blood transfusion in liver transplantation patients.Methods Retrospectively selected and classified 119 patients with liver transplantation medical recordsaccording to the clinical diagnosis of age,gender.Analyzed (disease)patients' blood coagulation index 24 h before surgery,intraoperative and postoperative perioperative bleeding,and blood red blood cell suspension,frozen plasma,cold precipitation,coagulation factor injection lossplateletpheresis.Results There were no significant differences in the amount of blood loss and the amount of blood preparations duringthe perioperative period of liver transplantation according to the age and sex of patients (P＞0.05);According to the clinical diagnosis of different groups,the diagnostic group (primary liver cancer group,hepatitis B cirrhosis group and severe hepatitis group) patients with a single platelet transfusion dosewas similar (P＞0.05)withsuspended red blood cells (U) at 8.4+11.9,16.2+15.7,18.1+13.5,frozen plasma (U) at 8.2+7.1,18.1+15.6 and 18.2+ 17.9 respectively andcold precipitation (U) at 9.5+ 8.2,17.1 + 16.318.5 + 16.4 (P＜ 0.05);The diagnosis group surgery before and after immediate PT (s) were 15.6+3.8,24.6+4.1,APTT (s) were 44.3+5.8,84.9+9.2,TT (s) were 20.4 +4.5,40.1+6.2,and Fib(s) were 2.6+0.8 and 1.3+0.9 (P＜0.05);however,there was no significant difference in the 24 h PT,APTT,TT and Fib between the two groups after diagnosis (P＞0.05).Conclusion Ascientific,safe and reasonable selection of perioperative blood preparation for clinical diagnosis for different liver transplantation patients is critical to the success rate and prognosis of liver transplantation;the evaluation of coagulation indexes at each interval can help guiding the blood transfusion during liver transplantation.
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Objective:To study the role of APACHEⅡscore pre-operation to infusion of blood preparation during the periods of hepatectomy.Methods:The correlation between APACHEⅡscore pre-operation and infusion of erythrocyte suspension and plasma were analyzed retrospectively in 104 cases who suffered from hepatectomy.Results:Those whose APACHEⅡscore were less than 5 had significantly lower volume of bleeding and lower infusion of erythrocyte suspension and plasma during the operation than those whose APACHEⅡscore were not less than 5(P