摘要
目的构建医疗机构临床用血量多元线性回归模型,为临床用血计划科学制订、考核评价和用血质量管理持续改进提供有效途径。方法 1)医院临床用血实施全面质量管理与持续改进;2)利用临床输血管理与评价信息系统采集2009-2014年医院临床用血数据,对临床用血量与出院患者人次及其增长率、输血出院患者人次、异体输血患者人次、自体输血患者人次、手术台次、输血手术台次、出院患者输血率、自体输血率、出院患者均异体用血量、成分构成比等质量指标进行相关分析,构建临床用血量多元线性回归模型。结果 1)临床用血量与输血出院患者人次、输血手术台次、异体输血手术台次、术中输血率、输血出院患者均异体RBC量间相关均不具统计学意义(P>0.05);成分血成分构成比在2009-2014各年度及均值间差异均不具统计学意义(P>0.05);2)临床用血量与出院患者人次、自体输血患者人次、手术台次、自体输血率间呈正相关(P<0.05),而与异体输血患者人次、出院患者输血率、出院患者异体输血率、出院患者均RBC量、出院患者均异体RBC量间呈负相关(P<0.05);异体输血患者人次、患者输血率、异体输血率、人均红细胞(RBC)用量、人均异体RBC用量均呈随患者自体输血增长而下降的变化趋势。3)临床用血量多元线性回归方程为Y=210 737.37-17.67×X1-3.54×X2+227 631.76×X3-149 980.71×X4(R2=1.0,P<0.05),回归方程检验具统计学意义(F=20 988.38,P<0.05),回归系数亦均具显著性意义(t=123.12、-77.94、-18.64、88.88、-71.77,P<0.05),临床用血量预测值与实际值间不具统计学意义(t=-0.159,P=0.88;P>0.05)。结论 1)异体输血患者人次、自体输血患者人次、自体输血率、出院患者均RBC用量、出院患者均异体RBC用量是医疗机构临床用血计划科学制订、考核评价和用血质量管理持续改进过程中减少患者输血需求,控制临床用血量及保护血液资源的有效质量控制指标;2)临床用血量多元线性回归方程对临床用血计划科学制订、考核评价和用血质量管理持续改进具有重要的指导意义。
Objective To construct multiple linear regression model on clinical usage amount of blood in medical institutions, and to provide an efficient way for scientific formulation and evaluation of clinical usage plan of blood and continuous improvement of clinical transfusion quality management. Methods Data on clinical blood use in our hospital from 2009 to 2014 were collected by the clinical transfusion management and evaluation system. The correlation of the clinical usage amount of blood to quality index of clinical transfusion with the number and growth rate of discharged patients, the number of transfusion patients and allogeneic transfusion patients and autologous transfusion patients, the number of surgery and transfusion surgery, the blood transfusion and autologous blood transfusion rate, the average allogeneic blood usage mount of dis- charged patients and the constituent ratio of blood component were analyzed. Multiple linear regression model on clinical usage amount of blood was constructed. Results It was not statistically significant for the correlation of clinical usage amount of blood to the number of transfusion patients, the number of transfusion surgery and allogeneic transfusion surgery, transfusion surgery rate, the average allogeneic red blood cells （RBC） amount of discharged transfusion patients （ P 〉 0. 05 ）. It was not statisticaUy significant for constitution ratio of blood components during 2009 - 2014 and their mean differences （ P 〉 0. 05）. Clinical usage amount of blood was positively correlated to the number of discharged patients and autologous transfusion patients, the number of surgery, autologous blood transfusion rate （P 〈 0.05）, and negatively correlated to the number of allogeneic transfusion patients, the rate of blood transfusion and allogeneic blood transfusion, average t/BC and allogeneic RBC usage amount of discharged patients（P 〈 0.05 ）, respectively. It was a downward trend for the number of allogeneic transfusion patients, blood transfusion and allogeneic blood transfusion rate, average RBC and allogeneic RBC usage amount with the growth of autologous blood transfusion in discharged patients. The multiple linear regression equation of clinical usage amount of blood was Y= 210 737. 37 - 17.67 × X1 - 3.54 × X2 ＋ 227 631.76 ×X3 - 149 980. 71 ×X4 （ha = 1.0, P 〈0. 05）,regression equation test with statistical significance （ F = 20 988.38, P 〈 0. 05 ）, regression coefficients so did （ t = 123. 12, - 77.94, - 18.64,88.88, - 71.77, P 〈 0. 05）. It was not statistically significant between the predicted value and actual value of clinical usage amount of blood （t = - 0. 159, P = 0. 88 ; P 〉 0. 05）. Conclusion The number of allogeneic trans- fusion patients and autologeus transfusion patients, autologous blood transfusion rate, average RBC and aUogeneic RBC a- mount of discharged patients are efficient quality control indices of clinical transfusion to reduce patient＇s transfusion require- ments in the process of scientific formulation and evaluation of clinical usage plan of blood and continuous improvement of clinical transfusion quality management. The multiple linear regression equation of clinical usage amount of blood has important guiding significance for scientific formulation and evaluation of clinical usage plan of blood and continuous improvement of clinical transfusion quality management.
出处
《中国输血杂志》
CAS
北大核心
2015年第8期1034-1037,共4页
Chinese Journal of Blood Transfusion
基金
江西省科技重大项目(20144BBG70001)
关键词
临床用血量
多元线性回归模型
临床用血计划
质量管理
clinical usage amount of blood
multiple linear regression model
clinical usage plan of blood
quality management
