2011-2017年广州血液中心血液报废原因分析
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摘要
目的通过分析广州血液中心血液制品报废量及其原因,降低血液报废率。方法收集2011-2017年的血液报废情况,针对不同的报废原因作回顾性分析。结果 2011-2017年广州血液中心共采集制备6 655 046 U血液,报废血液总量414 512 U,其中因实验室检测不合格报废的血量为216 488 U,报废率3.25%。实验室检测不合格血液报废率在2011-2017年逐年下降,其中最常见的原因是丙氨酸转移酶(ALT)(1.33%)不合格,其后依次是HBsAg(0.83%),梅毒(0.41%),抗?HCV(0.35%),核酸检测(0.21%)。非实验室检测不合格报废的血量为198 024 U,报废率2.98%。非实验室检测不合格血液报废率在2011-2017年逐年上升,并在2015年超过了实验室检测不合格血液报废率。乳糜血(2.37%)和破袋(0.15%)是非实验室检测不合格血液报废的主要原因。结论近7年血液报废主要原因构成有所变化,前4年以实验室检测报废为主,2015年开始以非实验室检测报废为主。应意识到血液报废的严重性并提出相应对策,减少血液报废,确保血液质量和输血安全。
Objective To analyze the amount of blood discarding in Guangzhou Blood Center and its causes,and reduce the blood discarding rate. Methods The dates of blood discarding from 2011 to 2017 were collected and the different reasons for discarding were analyzing by retrospective cohort study. Results A total of 6 655 046 U of blood was collected in Guangzhou Blood Center from 2011 to 2017,and a total of 414 512 U of blood were scrapped,in which 216 488 U(3.25%)were discarded due to laboratory detecting failure. The discarding rate due to laboratory detecting decreased year by year from 2011 to 2017. Alanine aminotransfease unqualified blood,followed by HBsAg(0.83%),syphilis(0.41%),anti?HCV(0.35%),nucleic acid detection(0.21%).The amount of blood that was not qualified for non?laboratory testing was 198 024 U,and the scrap rate was 2.98%. The non?laboratory test for unqualified blood scrap rate increased year by year in 2011-2017,and in 2015 exceeded the laboratory test for unqualified blood scrap rate. Celiac blood(2.37%)and broken bags(0.15%)were the main reasons for non?laboratory testing for unqualified blood. Conclusion In the past seven years,the main reason for blood discarding had changed. In the first four years laboratory detecing failure accounted for the majority whereas non?laboratory detecting became the main reason since 2015. We should be aware of the seriousness of blood discarding and propose corresponding countermeasures to reduce blood discarding and ensure blood quality and transfusion safety.
Objective To analyze the amount of blood discarding in Guangzhou Blood Center and its causes,and reduce the blood discarding rate. Methods The dates of blood discarding from 2011 to 2017 were collected and the different reasons for discarding were analyzing by retrospective cohort study. Results A total of 6 655 046 U of blood was collected in Guangzhou Blood Center from 2011 to 2017,and a total of 414 512 U of blood were scrapped,in which 216 488 U(3.25%)were discarded due to laboratory detecting failure. The discarding rate due to laboratory detecting decreased year by year from 2011 to 2017. Alanine aminotransfease unqualified blood,followed by HBsAg(0.83%),syphilis(0.41%),anti?HCV(0.35%),nucleic acid detection(0.21%).The amount of blood that was not qualified for non?laboratory testing was 198 024 U,and the scrap rate was 2.98%. The non?laboratory test for unqualified blood scrap rate increased year by year in 2011-2017,and in 2015 exceeded the laboratory test for unqualified blood scrap rate. Celiac blood(2.37%)and broken bags(0.15%)were the main reasons for non?laboratory testing for unqualified blood. Conclusion In the past seven years,the main reason for blood discarding had changed. In the first four years laboratory detecing failure accounted for the majority whereas non?laboratory detecting became the main reason since 2015. We should be aware of the seriousness of blood discarding and propose corresponding countermeasures to reduce blood discarding and ensure blood quality and transfusion safety.
引文
[1]周豪杰,李然,游冉冉.广州市非检测原因血液报废调查[J].热带医学杂志,2017,17(6):825-827.
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[4]张静,王素玲,赵莉华,等.无偿献血人群血液报废情况分析[J].临床血液学杂志:输血与检验,2016,29(4):666-668.
[5]徐国胜,黄可君,游冉冉.2010-2012年广州市无偿献血血液报废情况分析[J].热带医学杂志,2013,13(6):756-758.
[6]周源,白林,刘文,等.降低献血者丙氨酸转氨酶报废率的研究[J].中国药物与临床,2018,18(7):1118-1119.
[7]王霞,潘彤,李红珠,等.聚乙二醇消除乳糜血干扰ALT检测的实验研究[J].中国输血杂志,2014,27(9):956-958.
[8]Shi YH,Shi CH.Molecular characteristics and stages of chronic hepatitis B virus infection[J].World J Gastroenterol,2009,15(25):3099-3105.
[9]王静,林红,周春,等.南京地区无偿献血者HCV感染流行病学分析[J].中国输血杂志,2017,30(7):803-805.
[10]陈秀兰,李振,吴洁,等.两种核酸系统在无偿献血检测中的性能比较[J].临床输血与检验,2018,20(1):47-50.
[11]李文慧,李玲,刘忠.无偿献血者HTLV筛查研究进展[J].中国输血杂志,2017,30(3):231-234.
[12]林杰,黄国永,刘燕飞,等.温州地区无偿献血者人类嗜T淋巴细胞白血病病毒感染情况分析[J].中国输血杂志,2017,30(7):794-795.
[13]张红梅,郭楠,王洪.某市无偿献血者乳糜血相关因素调查分析[J].解放军预防医学杂志,2017,35(5):454-456.
[14]李强,张秀军,孙良,等.2011-2015年阜阳市无偿献血血液报废原因分析[J].蚌埠医学院学报,2018,43(8):1085-1087.
[15]曹锁春,何亚琴,马天虹.血液离心渗漏原因分析及预防改进对策[J].临床血液学杂志:输血与检验,2017,30(2):312-313.
[16]梁洁贞,陈尚良,廖扬勋.采血不足量原因分析与对策[J].热带医学杂志,2015,15(11):1574-1576.
[2]尚卢清.血站非检测不合格血液报废的原因与预防措施[J].世界最新医学信息文摘,2015,15(16):9-10.
[3]中华人民共和国卫生部.血站技术操作规程(2015版)[EB/OL].(2015-12-17).http://www.nhfpc.gov.cn/yzygj/s7658/201512/d9c61cbe48c14b88ab82ebae72036223.shtml.
[4]张静,王素玲,赵莉华,等.无偿献血人群血液报废情况分析[J].临床血液学杂志:输血与检验,2016,29(4):666-668.
[5]徐国胜,黄可君,游冉冉.2010-2012年广州市无偿献血血液报废情况分析[J].热带医学杂志,2013,13(6):756-758.
[6]周源,白林,刘文,等.降低献血者丙氨酸转氨酶报废率的研究[J].中国药物与临床,2018,18(7):1118-1119.
[7]王霞,潘彤,李红珠,等.聚乙二醇消除乳糜血干扰ALT检测的实验研究[J].中国输血杂志,2014,27(9):956-958.
[8]Shi YH,Shi CH.Molecular characteristics and stages of chronic hepatitis B virus infection[J].World J Gastroenterol,2009,15(25):3099-3105.
[9]王静,林红,周春,等.南京地区无偿献血者HCV感染流行病学分析[J].中国输血杂志,2017,30(7):803-805.
[10]陈秀兰,李振,吴洁,等.两种核酸系统在无偿献血检测中的性能比较[J].临床输血与检验,2018,20(1):47-50.
[11]李文慧,李玲,刘忠.无偿献血者HTLV筛查研究进展[J].中国输血杂志,2017,30(3):231-234.
[12]林杰,黄国永,刘燕飞,等.温州地区无偿献血者人类嗜T淋巴细胞白血病病毒感染情况分析[J].中国输血杂志,2017,30(7):794-795.
[13]张红梅,郭楠,王洪.某市无偿献血者乳糜血相关因素调查分析[J].解放军预防医学杂志,2017,35(5):454-456.
[14]李强,张秀军,孙良,等.2011-2015年阜阳市无偿献血血液报废原因分析[J].蚌埠医学院学报,2018,43(8):1085-1087.
[15]曹锁春,何亚琴,马天虹.血液离心渗漏原因分析及预防改进对策[J].临床血液学杂志:输血与检验,2017,30(2):312-313.
[16]梁洁贞,陈尚良,廖扬勋.采血不足量原因分析与对策[J].热带医学杂志,2015,15(11):1574-1576.