發(fā)布時(shí)間：2018-05-27 01:36

  本文選題：地中海貧血 + 輸血治療��； 參考：《中國(guó)輸血雜志》2017年08期

【摘要】：目的了解南寧市需要定期輸血的重癥地中海貧血(簡(jiǎn)稱地貧)患兒輸血基本情況及與南寧周邊城市的差異,逐步解決重癥地貧患兒輸血難的問(wèn)題。方法問(wèn)卷調(diào)查與病案調(diào)查相結(jié)合,自制調(diào)查問(wèn)卷,調(diào)查內(nèi)容包括重癥地貧患兒基本情況(性別、地貧遺傳史、戶籍)、輸血醫(yī)療費(fèi)用情況(家庭月收入、醫(yī)療費(fèi)用類型、輸血自行承擔(dān)費(fèi)用)、輸血情況(首次輸血年齡、至今輸血病程、輸血次數(shù)、輸血量)、血液供應(yīng)情況(能否按期輸血、能否足量輸血)等,收集南寧市區(qū)[廣西醫(yī)科大學(xué)第一附屬醫(yī)院(簡(jiǎn)稱廣西醫(yī)大一附院)地貧之家、解放軍303醫(yī)院(簡(jiǎn)稱303醫(yī)院)地貧之家](階段性問(wèn)卷調(diào)查,2013年11月-2014年1月),廣西欽州市、河池市、百色市、來(lái)賓市、玉林市等5市(抽樣問(wèn)卷調(diào)查,2013年8月-2013年9月)以及南寧市轄武鳴、橫縣、賓陽(yáng)、上林、馬山、隆安6縣(2008年11月-2013年10月回顧性問(wèn)卷調(diào)查)共850份重癥地貧患兒調(diào)查問(wèn)卷,通過(guò)對(duì)調(diào)查數(shù)據(jù)的統(tǒng)計(jì)分析,制定并逐步實(shí)施南寧6縣地貧患兒供血方案,依據(jù)該供血方案把握地貧患兒的供血情況及發(fā)展趨勢(shì)。結(jié)果 1)南寧及其周邊5市465名地貧患兒輸血情況調(diào)查顯示,6市地貧患兒在戶籍構(gòu)成比例、醫(yī)療費(fèi)用類型、輸血承擔(dān)費(fèi)用、輸血病程、累計(jì)輸血量、能否按期輸血等方面人群分布率存在差異(P0.05)。2)廣西醫(yī)大一附院地貧之家及303醫(yī)院地貧之家連續(xù)60 d 356份重癥地貧患兒輸血情況調(diào)查顯示,2家地貧之家重癥地貧患兒在家庭收入、累計(jì)輸血量方面群分布率存在差異(P0.05)。3)2008年11月-2013年10月南寧市轄6縣391例重癥地貧患兒輸血病案回顧性調(diào)查顯示,6個(gè)縣重癥地貧患兒在首次輸血年齡、輸血病程、輸血次數(shù)、累計(jì)輸血量、能否按期輸血、能否充足供血等方面人群分布率存在差異(P0.01)。4)建立了衛(wèi)生行政部門(mén)領(lǐng)導(dǎo),由地貧患兒、醫(yī)療機(jī)構(gòu)、血站、無(wú)償獻(xiàn)血者構(gòu)成的聯(lián)動(dòng)機(jī)制,優(yōu)先解決南寧6縣地貧患兒供血。各縣指定地貧患兒定點(diǎn)輸血醫(yī)院,血站每月分3個(gè)時(shí)段向地貧患兒輸血的醫(yī)院供血,輸血的地貧兒童基本資料登記備案,包括兒童基本信息、血型、輸血頻率及輸血用量等;地貧患兒經(jīng)治醫(yī)師每次用血提前3 d向定點(diǎn)醫(yī)院輸血科申請(qǐng),由定點(diǎn)醫(yī)院輸血科向血站供血科預(yù)約供血量,血站輸血科審核通過(guò)后,按時(shí)將血液備齊由各定點(diǎn)輸血醫(yī)院按時(shí)領(lǐng)用。5)南寧市轄6縣重癥地貧患兒供血方案于2013年3月起逐步實(shí)施,截止2016年6月,各縣重癥地貧患兒用血量占比縣全年用血量逐年升高(P0.01)。結(jié)論重癥地貧患兒的規(guī)范輸血宜施行屬地化管理,做到唯一性編碼登記在冊(cè),依據(jù)在冊(cè)登記,開(kāi)展統(tǒng)一重癥地貧患兒基本情況及定期輸血情況的基線調(diào)查,能夠了解各地在一段時(shí)間內(nèi)重癥地貧患兒的輸血治療現(xiàn)狀,預(yù)測(cè)其發(fā)展趨勢(shì),同時(shí)為血站保障重癥地貧患兒的醫(yī)療用血提供依據(jù)。
[Abstract]:Objective to understand the basic situation of blood transfusion in children with severe thalassemia (thalassemia) who need regular blood transfusion in Nanning and the difference between them and the surrounding cities in Nanning, so as to solve the difficulty of blood transfusion in children with severe thalassemia. Methods A self-made questionnaire was made by combining the questionnaire survey with the medical record survey. The contents of the questionnaire included the basic situation of the children with severe thalassemia (sex, genetic history of thalassemia, household registration), medical expenses of blood transfusion (monthly income of family, type of medical expenses). Blood transfusions bear their own expenses, and blood transfusion (age of first transfusion, course of blood transfusion to date, number of blood transfusions, volume of blood transfusions), blood supply (whether blood can be transfused on schedule, whether blood can be given in sufficient quantities), etc. Nanning City [the first affiliated Hospital of Guangxi Medical University (referred to as the first affiliated Hospital of Guangxi Medical University) is a poor family, and the PLA 303 hospital (abbreviated as 303 hospital) is a poor family] (periodic questionnaire survey, November 2013-January 2014, Qinzhou City, Guangxi, China), Hechi City, Baise City, Laibin City, Yulin City and other cities (sampling questionnaire survey, August 2013-September 2013) and Wuming, Hengxian, Binyang, Shanglin, Ma Shan, Nanning City, A total of 850 questionnaires for children with severe thalassemia were collected in 6 counties (November 2008 to October 2013). Based on the statistical analysis of the survey data, a blood supply program for children with thalassemia in 6 counties of Nanning was formulated and implemented step by step. According to the blood supply program, the blood supply situation and development trend of children with thalassemia were grasped. Results 1) A survey of 465 children with thalassemia in Nanning and its surrounding cities showed that the proportion of household registration, the type of medical expenses, the cost of blood transfusion, the course of blood transfusion and the cumulative amount of blood transfusion were found in the children with thalassemia. There is a difference in the distribution rate of population in terms of blood transfusion on schedule (P0.05. 2) the investigation on the blood transfusion status of 356 children with severe thalassemia in Guangxi first affiliated Hospital and 303 Hospital for 60 days showed that there were 2 families with severe thalassemia in their family income. From November 2008 to October 2013, a retrospective investigation of 391 cases of severe thalassemia in Nanning City showed that the age of first blood transfusion, the course of blood transfusion and the number of times of transfusion were observed in the first transfusion age, the course of transfusion, and the number of blood transfusions in the children with severe thalassemia in 6 counties. There is a difference in the population distribution rate in terms of accumulative blood transfusion, regular blood transfusion and adequate blood supply. (P0.01k.4) has established a linkage mechanism composed of children with thalassemia, medical institutions, blood stations, and unpaid blood donors, under the leadership of the health administration department. Priority should be given to the blood supply of children with thalassemia in 6 counties of Nanning. The designated blood transfusion hospital for children with thalassemia in each county was divided into 3 times a month by blood station to supply blood to the hospital where children with thalassemia were given blood transfusion. The basic data of children with thalassemia were registered and recorded, including basic information of children, blood type, frequency of blood transfusion and dosage of blood transfusion. The child with thalassemia applied to the blood transfusion department of the designated hospital 3 days in advance for each time. The blood transfusion department of the designated hospital made an appointment to the blood supply department of the blood station, and the blood transfusion department of the blood station passed the examination and approval. The program of blood supply for children with severe thalassemia in 6 counties of Nanning City was gradually implemented in March 2013, and as of June 2016, The proportion of blood consumption in children with severe thalassemia increased year by year (P 0.01). Conclusion the standardized blood transfusion in children with severe thalassemia should be managed locally, and the registration of unique codes should be carried out. According to the registration, the baseline investigation on the basic situation and regular blood transfusion of children with severe thalassemia should be carried out. It can understand the current situation of blood transfusion treatment for children with severe thalassemia over a period of time, predict its development trend, and provide the basis for blood station to guarantee the medical use of blood for children with severe thalassemia.
【作者單位】： 南寧中心血站;
【基金】：廣西壯族自治區(qū)衛(wèi)生廳科研課題(Z2012667)
【分類號(hào)】：R556.61
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本文編號(hào)：1939845