某医院临床输血不良反应调查与分析

目的通过对各类成分血液输血反应发生频率和输血反应类型的调查分析,以提高临床医护人员对输血反应的认识和处理能力。方法对某院2005年1月～2010年2月各种成分输血后所发生的输血反应进行回顾分析。结果在139 852单位输血中,共发生输血反应143次,总输血反应率为0.10%,输注全血反应率最高为0.99%,红细胞悬液0.14%,冰冻血浆0.07%,血小板0.05%,滤白红细胞0.01%,自体输血无输血反应。输血单位为1,2,3,4和≥5单位的构成比分别为0.03%、0.06%、0.31%、0.41%和1.12%。血液内科、其他科室与外科患者反应频率的差异有统计学意义(P<0.01)。输血反应表现类型以非溶血性发热反应最多见,占62.94%,其次是过敏反应,占32.16%。结论自体输血和去除白细胞悬浮红细胞输注能有效降低输血反应发生率,对多次输血的患者,应输注去除白细胞悬浮红细胞,以减少输血反应的发生。预防性用药可减少轻度的输血反应。     

2004～2010年某院临床用血情况分析

目的 通过对临床成分用血现状分析,指导临床合理用血.方法 对2004～2010年该院治疗患者总数、手术总数、临床用血总量和各种血液制品用量占本年度用血总量比例进行统计.同时对2008～2010年用血量较大的科室各种成分血输血率进行分析.结果 2004～2010年间该院门诊患者数、住院患者数和手术数量呈逐年递增趋势,临床用血总量和红细胞使用量无明显变化,全血使用量逐年减少,血小板和冷沉淀使用量逐年上升,成分输血率均达99%以上,但仍存在一定的不合理性.2004～2007年间血浆为临床输血主要成分,2008～2010年红细胞为临床输血的主要成分,血浆用量逐年递减,血小板和冷沉淀用量逐年增多.结论 该院成分输血逐步向科学化、合理化和规范化的方向发展,成分输血结构明显改善.     

Discharge haematocrit as clinical indicator for blood transfusion audit in surgery patients

SUMMARY. Three cohorts of elective surgical patients were reviewed in order to develop a method in which the discharge haematocrit can serve as a clinical indicator for a subsequent study of the use of blood transfusion therapy. Three different levels of discharge haematocrit were evaluated: 36, 33, and 30% for ‘generous’, ‘intermediate’, and ‘strict’ criteria, respectively. Discharge haematocrits (%, mean ± SD) for patients not transfused were 29.6±4.6, 33.7 ± 5.0, and 33.6 ± 3.4 for three different surgical groups (cardiac, orthopaedic, and urological surgical patients). When discharge haematocrits greater than 33% (‘intermediate’) were considered excessive due to previous transfusion, the prevalence of patients identified was 9, 6.5 and 13%, respectively. We found no relationship between the length of stay in hospital and the number of blood units transfused or patient discharge haematocrit levels. When the length of stay of patients identified by exceeding the clinical indicator was compared to that of patients not identified, orthopaedic and urological surgical patients showed no difference; however, cardiac surgical patients who exceeded the clinical indicator had shorter hospital stays compared to patients who were not so identified. We conclude the following: 1 The discharge haematocrit can be used as a clinical indicator for a subsequent review of use in order to evaluate the appropriateness of blood transfusion therapy. 2 The prevalence of patients identified who exceeded the clinical indicator, among three elective surgical patient groups, suggests that this indicator is applicable across elective surgical categories in order to target transfusion medicine education programmes and clinical outcome studies. 3 Additional factors important to the ‘transfusion trigger’, such as blood lost during hospitalization, may need to be included with the discharge haematocrit as clinical indicators in order to evaluate blood transfusion therapy in this setting.     

Neonatal exchange transfusion: Experience in Korea

BackgroundExchange transfusion (ET) is an established, efficacious, and reliable practice for severe neonatal hyperbilirubinemia, hemolytic disease of the newborn, and neonatal sepsis. This study assessed the indications and clinical outcomes of ET performed in a tertiary hospital in Korea.Materials and methodsWe studied 64 ET sessions performed on 23 neonates between March 1999 and March 2018. ET was performed based on estimated double volume exchange transfusion using fresh red blood cells and fresh frozen plasma. Patients’ clinical information, including demographic data and ET indication, and laboratory data were collected pre- and post-ET.ResultsThe most common ET indication was hyperbilirubinemia with hemolytic anemia due to non-ABO maternal blood group discrepancies. In three preterm babies, ETs were performed for severe anemia, leukocytosis, and hyperkalemia cases. Before ET, the patients showed slightly high WBC counts, low hemoglobin levels, and low platelet counts. After ET, blood examination revealed normal WBC counts, increased hemoglobin levels, and decreased platelet counts (all P < 0.001). Bilirubin levels decreased immediately after ET (P < 0.001). Electrolyte and C-reactive protein levels showed no significant changes after ETs. Adverse events occurred in 11 (47.8 %) patients; the most common were hypoxemia and hypotension. One infant experienced cardiorespiratory arrest due to hypercalcemia and was successfully resuscitated. No one died within 24 h of ET. However, five infants showed hyperbilirubinemia aggravation.ConclusionsET is an effective treatment modality for leukocytosis and hyperbilirubinemia with low mortality but involves common adverse events post-ET. This report provides an overview of current ET practices in Korea.     

Immunohematologic aspects of alloimmunization and alloantibody detection: A focus on pregnancy and hemolytic disease of the fetus and newborn

Alloimmunization to non-ABO, red blood cell (RBC) antigens remains one of the most clinically-relevant complexities faced by blood banking practitioners. In the setting of transfusion therapy, these antibodies raise risks for incompatibilities, while for pregnant patients they can mediate deadly forms of hemolytic disease of the fetus and newborn. As such, a thorough understanding of pathways that lead to alloimmunization, as well as the tools used by blood banks to detect alloantibodies, is critical to transfusion practice. In this review, in which alloimmunization in the setting of pregnancy will be emphasized, we will review: 1) the clinical impacts of RBC alloantibodies in the peri-partum period; 2) the current pathophysiologic mechanisms thought to influence non-ABO antigen alloimmunization; 3) the strengths and weaknesses of laboratory tools used in aiding alloimmunization detection; and 4) future directions of the transfusion community related to alloimmunization impacting pregnancy.     

新生儿高胆红素血症换血治疗用血情况分析

目的通过调查单病种临床用血量,对我院新生儿高胆红素血症接受换血治疗的用血情况进行统计和分析,为临床合理用血提供有价值的依据。方法对我院2016年1月~2019年12月新生儿高胆红素血症接受换血治疗的389例患儿的临床资料进行回顾性分析,分别统计患儿的一般情况,并对换血治疗中用血量进行分析统计。结果389例患儿中男212例,女177例,性别差异无统计学意义(P>0.05);A型155例,B型128例,O型80例,AB型26例,患儿血型比较有统计学差异(P<0.001),高胆红素血症患者中O型血患儿换血最少,A型与B型无统计学差异(P>0.05);换血治疗多选用新鲜O型红细胞悬液和AB型新鲜冰冻血浆,O型红细胞用量共计1060 U,占红细胞总量86.14%,AB型血浆49050 mL,占血浆用量的75.81%,平均每例用血量为红细胞悬液3.13 U,新鲜冰冻血浆165 mL。结论通过对新生儿换血用血的分析,总结出用血经验,为优化用血方案提供依据,有效治疗的同时合理用血,节约用血。     

非自身免疫性溶血性贫血患者直接抗人球蛋白试验阳性对临床输血效果影响

目的:研究非AIHA患者DAT阳性对临床输血效果影响。方法:收集多个科室96例DAT阳性的非AIHA输血者为阳性组,均分为甲组(48例输注洗涤红细胞)和乙组(48例输注普通红细胞悬液),对照组为58例DAT阴性的常规输血患者。采用微柱凝胶法(MGT)和凝聚胺法进行交叉配血。检测患者红细胞(RBC)、血红蛋白(Hb)、红细胞平均血红蛋白量(MCH)。结果:阳性组ICU患者62例(64.6%),血液系统疾病12例(12.5%),循环系统疾病9例(9.4%),肿瘤6例(6.3%),消化系统疾病3例(3.1%),内分泌系统疾病2例(2.1%),呼吸系统疾病2例(2.1%)。交叉配血结果显示,MGT阳性组主侧为阴性,次侧为阳性,凝聚胺法阳性组和对照组主侧次侧均为阴性;RBC计数、Hb浓度、MCH,输血后甲组、乙组、对照组均高于输血前(P<0.05);输血后三组互相比较差异均无统计学意义(P>0.05);所有患者均未见严重输血不良反应。结论:DAT阳性的非AIHA患者输注普通红细胞悬液是安全有效的,对临床制定输血方案具有指导意义。     

人工血红蛋白的最新应用进展

输血治疗是临床治疗中不可或缺的重要手段.从20世纪70年代开始,随着血液制品的大量临床应用,使其安全性问题逐渐进入人们的视线.全球性的血液储备不足,血液制品相关疾病的传播等问题促使研究者积极开发更加安全、有效的人工血液,现阶段的研究主要聚焦于某种血液细胞成分的功能替代物的研发.自1930年以来,人们在替代红细胞功能的人工载氧体,如人工血红蛋白(Hb)领域,进行了大量的基础研究和临床试验.笔者拟主要针对以Hb为基础的人工载氧体和以蚯蚓血红蛋白(Hr)为基础的人工载氧体的最新应用进展进行阐述.     

Promise of gene therapy to treat sickle cell disease

ABSTRACT

Introduction: Sickle cell anemia (SCA) is a hereditary blood disease caused by a single-gene mutation that affects millions of individuals world-wide. In this review, we focus on techniques to treat SCA by ex vivo genetic manipulation of hematopoietic stem/progenitor cells (HSPC), emphasizing replacement gene therapy and gene editing.

Areas covered: Viral transduction of an anti-sickling β-like globin gene has been tested in pre-clinical and early-phase clinical studies, and shows promising preliminary results. Targeted editing of endogenous genes by site-directed nucleases has been developed more recently, and several approaches also are nearing clinical translation.

Expert commentary: The indications and timing of gene therapy for SCA in lieu of supportive care treatment and allogeneic hematopoietic cell transplantation are still undefined. In addition, ensuring access to the treatment where the disease is endemic will present important challenges that must be addressed. Nonetheless, gene therapy and gene editing techniques have transformative potential as a universal curative option in SCA.     

Three years of haemovigilance in a general university hospital

The aim of this study is to describe a newly implemented haemovigilance system in a general university hospital. We present a series of short cases, highlighting particular aspects of the reports, and an overview of all reported incidents between 1999 and 2001. Incidents related to transfusion of blood products were reported by the clinicians using a standard preformatted form, giving a synopsis of the incident. After analysis, we distinguished, on the one hand, transfusion reactions, that are transfusions which engendered signs or symptoms, and, on the other hand, the incidents where management errors and/or dysfunctions took place. Over 3 years, 233 incidents were reported, corresponding to 4.2 events for 1000 blood products delivered. Of the 233, 198 (85%) were acute transfusion reactions and 35 (15%) were management errors and/or dysfunctions. Platelet units gave rise to statistically (P < 0.001) more transfusion reactions (10.7 per thousand ) than red blood cells (3.5 per thousand ) and fresh frozen plasma (0.8 per thousand ), particularly febrile nonhaemolytic transfusion reactions and allergic reactions. A detailed analysis of some of the transfusion incident reports revealed complex deviations and/or failures of the procedures in place in the hospital, allowing the implementation of corrective and preventive measures. Thus, the haemovigilance system in place in the 'Centre Hospitalier Universitaire Vaudois, CHUV' appears to constitute an excellent instrument for monitoring the security of blood transfusion.     

某三甲医院131例次输血不良反应回顾性分析

目的分析该院近4年输血不良反应的发生情况和患者的输注效果,为临床输血安全性和有效性管理提供依据。方法回顾该院2015-2018年《输血不良反应反馈单》及相关记录,分析输血不良反应的分布情况和特点,收集相关数据分析发生输血不良反应患者的输注效果。结果2015-2018年共输血35363例次,发生输血不良反应131例次,总发生率为0.37%,输血不良反应发生率呈逐年下降趋势。各年龄段人群均有输血不良反应发生,随年龄增长呈先上升后下降趋势;女性患者输血不良反应发生率明显高于男性(P<0.05)。输血不良反应主要为发热反应和过敏反应,分别占57.25%和38.17%。不同血液成分输血不良反应发生率以血小板最高,为0.78%,悬浮红细胞次之,为0.41%。悬浮红细胞输血不良反应发生例次随自体血回输增多而逐年递减。输注同样剂量悬浮红细胞和血小板,病例组输注效果均明显差于对照组(P<0.05)。结论该院输血不良反应发生率逐年降低,自体血回输对减少悬浮红细胞输血不良反应有一定作用。临床工作中应严格把握血液成分输注指征,持续开展并扩大自体输血覆盖面,保障临床科学、合理、安全用血。     

Hitchhiker's guide to the red cell storage galaxy: Omics technologies and the quality issue

Red blood cell storage in the blood bank makes millions of units of available for transfusion to civilian and military recipients every year. From glass bottles to plastic bags, from anticoagulants to complex additives, from whole blood to leukocyte filtered packed red blood cells: huge strides have been made in the field of blood component processing and storage in the blood bank during the last century. Still, refrigerated preservation of packed red blood cells under blood bank conditions results in the progressive accumulation of a wide series of biochemical and morphological changes to the stored erythrocytes, collectively referred to as the storage lesion(s). Approximately ten years ago, retrospective clinical evidence had suggested that such lesion(s) may be clinically relevant and mediate some of the untoward transfusion-related effects observed especially in some categories of recipients at risk (e.g. massively or chronically transfused recipients). Since then, randomized clinical trials have failed to prospectively detect any signal related to red cell storage duration and increased morbidity and mortality in several categories of recipients, at the limits of the statistical power of these studies. While a good part of the transfusion community has immediately adopted the take-home message “if it isn’t broken, don’t fix it” (i.e. no change to the standard of practice should be pursued), decision makers have been further questioning whether there may be room for further improvements in this field. Provocatively, we argue that consensus has yet to be unanimously reached on what makes a good quality marker of the red cell storage lesion and transfusion safety/efficacy. In other words, if it is true that “you can’t manage what you can’t measure”, then future advancements in the field of transfusion medicine will necessarily rely on state of the art analytical omics technologies of well-defined quality parameters. Heavily borrowing from Douglas Adam's imaginary repertoire from the world famous “Hitchhiker's guide to the galaxy”, we briefly summarize how some of the principles for intergalactic hitchhikers may indeed apply to inform navigation through the complex universe of red cell storage quality, safety and efficacy.     

SARS-CoV-2 variants inactivation of plasma units using a riboflavin and ultraviolet light-based photochemical treatment

BackgroundTest the ability of Mirasol Pathogen Reduction Technology (PRT, Terumo BCT, Lakewood Co, USA) treatment with riboflavin and ultraviolet light (R + UV) in reducing SARS-CoV-2 infectivity while maintaining blood product quality.Material and methodsSARS-CoV-2 strains were isolated and titrated to prepare cell free virus for plasma units infection. The units were then under treatment with Mirasol PRT. The infectious titers were determined before and after treatment with an in house microtitration assay on Vero E6 cells. Thirty-six plasma pool bags underwent PRT treatment.ResultsIn all the experiments, the measured titer following riboflavin and UV treatment was below the limit of detection of microtitration assay for all the different SARS-CoV-2 strains. Despite the high copies number detected by RT-PCR for each viral strain after treatment, viruses were completely inactivated and not able to infect VERO E6 cells.ConclusionRiboflavin and UV light treatment effectively reduced the virus titers of human plasma to the limit of detection in tissue culture, regardless of the strain. These data suggest that pathogen reduction in blood products highlight the safety of CP therapy procedures for critically ill COVID-19 patients, while maintaining blood product quality.     

长沙市20家医院自体输血开展情况调查报告

目的了解长沙市各级医疗机构自体输血开展情况,促进本地区自体输血在临床中规范、安全地应用。方法通过现场走访,填写调查问卷表,对长沙市用血量前20家医疗机构2012-2017年自体输血的开展情况及制约因素等进行调研。结果 2012-2017年长沙地区用血量前20家医院平均自体输血开展率为31.7%,某部级、省级、市级医院2012-2017年平均自体输血率分别为:12.07%、2.27%、13.32%。自体输血类型以术中输血的回收式为主。结论长沙地区较大型的三甲医院已逐步开展自体输血并取得一定成效。自体输血是临床输血的重要组成部分,大力推广和实施自体输血仍任重而道远。     

Hepatitis C Virus Genotype 5a Subgenomic Replicons for Evaluation of Direct-Acting Antiviral Agents

Hepatitis C virus (HCV) exists as six major genotypes that differ in geographical distribution, pathogenesis, and response to antiviral therapy. In vitro replication systems for all HCV genotypes except genotype 5 have been reported. In this study, we recovered genotype 5a full-length genomes from four infected voluntary blood donors in South Africa and established a G418-selectable subgenomic replicon system using one of these strains. The replicon derived from the wild-type sequence failed to replicate in Huh-7.5 cells. However, the inclusion of the S2205I amino acid substitution, a cell culture-adaptive change originally described for a genotype 1b replicon, resulted in a small number of G418-resistant cell colonies. HCV RNA replication in these cells was confirmed by quantification of viral RNA and detection of the nonstructural protein NS5A. Sequence analysis of the viral RNAs isolated from multiple independent cell clones revealed the presence of several nonsynonymous mutations, which were localized mainly in the NS3 protein. These mutations, when introduced back into the parental backbone, significantly increased colony formation. To facilitate convenient monitoring of HCV RNA replication levels, the mutant with the highest replication level was further modified to express a fusion protein of firefly luciferase and neomycin phosphotransferase. Using such replicons from genotypes 1a, 1b, 2a, 3a, 4a, and 5a, we compared the effects of various HCV inhibitors on their replication. In conclusion, we have established an in vitro replication system for HCV genotype 5a, which will be useful for the development of pan-genotype anti-HCV compounds.     

Joint Trauma System,Defense Committee on Trauma,and Armed Services Blood Program consensus statement on whole blood

Hemorrhage is the most common mechanism of death in battlefield casualties with potentially survivable injuries. There is evidence that early blood product transfusion saves lives among combat casualties. When compared to component therapy, fresh whole blood transfusion improves outcomes in military settings. Cold-stored whole blood also improves outcomes in trauma patients. Whole blood has the advantage of providing red cells, plasma, and platelets together in a single unit, which simplifies and speeds the process of resuscitation, particularly in austere environments. The Joint Trauma System, the Defense Committee on Trauma, and the Armed Services Blood Program endorse the following: (1) whole blood should be used to treat hemorrhagic shock; (2) low-titer group O whole blood is the resuscitation product of choice for the treatment of hemorrhagic shock for all casualties at all roles of care; (3) whole blood should be available within 30 min of casualty wounding, on all medical evacuation platforms, and at all resuscitation and surgical team locations; (4) when whole blood is not available, component therapy should be available within 30 min of casualty wounding; (5) all prehospital medical providers should be trained and logistically supported to screen donors, collect fresh whole blood from designated donors, transfuse blood products, recognize and treat transfusion reactions, and complete the minimum documentation requirements; (6) all deploying military personnel should undergo walking blood bank prescreen laboratory testing for transfusion transmitted disease immediately prior to deployment. Those who are blood group O should undergo anti-A/anti-B antibody titer testing.     

不同自体输血方式的临床效果研究

目的 探讨不同自体输血方式的有效性,促进医疗机构开展自体输血工作,保障临床输血安全.方法 采用简单随机抽样法随机选择2014年1月至2016年7月,于北京军区总医院或大连中心医院行骨科手术的88例自体输血患者作为研究对象.采用简单随机分组法,将其随机分为,术中自体红细胞回输组(n=43),储存式自体全血回输组(n=25)及储存式自体单采红细胞回输组(n=20).采用简单随机抽样法,选择同期42例于受试者收集医院行骨科手术,并且术中仅接受异体输血的患者,纳入对照组(n=42).记录并分析采血前/术前、输血后当天、输血后第4天,各组患者红细胞计数、血红蛋白(Hb)水平、血细胞比容(HCT)、血小板计数,以及患者住院天数、术中出血量、异体输血量等指标.采用统计学方法比较4组患者上述各项指标的差异.结果 ①本研究4组患者采血前/术前的红细胞计数、Hb水平、HCT、血小板计数分别比较,差异均无统计学意义(P＞0.05).②输血后当天:4组患者的红细胞计数、Hb水平、HCT分别比较,差异均无统计学意义(P＞0.05);4组患者的血小板计数比较,差异有统计学意义(F=4.157,P=0.008).其中,储存式自体全血回输组患者的血小板计数最高[(196.0±43.8)×109/L],高于术中自体红细胞回输组、对照组,并且差异均有统计学意义(P=0.004、0.009);但是,与储存式自体单采红细胞回输组比较,差异无统计学意义(P=0.653).③输血后第4天:4组患者的红细胞计数比较,差异无统计学意义(P＞0.05);4组患者的Hb水平比较,差异有统计学意义(F=3.764,P=0.013).其中,术中自体红细胞回输组的Hb水平最高[(115.6±23.8)g/L],高于储存式自体全血回输组及对照组,并且差异均有统计学意义(P=0.022、0.006);但是,与储存式自体单采红细胞回输组比较,差异无统计学意义(P=0.878).4组患者的HCT比较,差异有统计学意义(F=3.915,P=0.011).其中,储存式自体单采红细胞回输组HCT最高[(34.4=4.8)％],高于对照组,并且差异有统计学意义(P=0.012);但是,与储存式自体全血回输组及术中自体红细胞回输组分别比较,差异均无统计学意义(P=0.059、0.819).④4组患者术中出血量和异体输血量分别比较,差异均无统计学意义(P＞0.05).4组患者住院天数比较,差异有统计学意义(x2=11.990,P=0.007).其中,对照组患者的住院天数最长[14.5 d(9.5～16.0 d)],长于储存式自体全血回输组,并且差异有统计学意义(P=0.007);但是,与储存式自体单采红细胞回输注及术中自体红细胞回输组分别比较,差异均无统计学意义(P=0.09、0.944).结论 临床择期外科手术患者的自体输血方式,首选储存式自体单采红细胞回输,其次为储存式自体全血回输和术中自体红细胞回输.在不能达到自体输血要求时,可选择异体输血.临床医师需要转变观念,逐步降低异体输血率,广泛、有效地开展自体输血工作,进一步保障临床输血安全.     

P-Null Phenotype Due to a Rare Frame-Shift Mutation and with Allo-Anti-PP1Pk Causing a Severe Hemolytic Transfusion Reaction: A Case Report with Clinical Management

IntroductionThe identification of alloantibodies to high-frequency antigens (HFA) and subsequent transfusion management can be challenging and often poses a problem in finding the compatible blood for transfusion. The aim of this study was to investigate the specificity of the antibody to the HFA causing a hemolytic transfusion reaction (HTR) and procure the compatible blood unit for future transfusion.Case presentationA 4-year-old female met with a head injury that led to intracranial bleeding and surgical intervention was required to remove blood clots. In the face of anemia, blood transfusion was planned. The pretransfusion tests on her blood sample revealed the presence of a pan-reactive alloantibody with hemolytic properties. She was transfused with 10 mL of the least incompatible red blood cells (RBCs) to which she reacted with signs of clinical hemolysis, i.e., chill, rigor, fever, and hemoglobinuria, on 3 different occasions. Despite her anemia, she was managed by medical intervention only. Her antibody reacted with all RBCs tested, except autologous and P-null (p phenotype) cells. Her RBCs did not react with anti-PP1Pk, which corroborated her phenotype as P-null. The genomic study revealed she was hemi- or homozygous or for a deletion of 26-bp in A4GALTexon 3, previously reported as causing the P-null phenotype and designated A4GALT*01N.019.ConclusionThis report documents a rare case of the P-null phenotype with an alloanti-PP1Pk causing a severe HTR to transfusion of the trial dose of the least incompatible blood. The case is the first example of this specific A4GALTmutation found in India.     

西藏自治区人民医院2014~2018年临床用血情况分析

目的了解西藏自治区人民医院(简称自治区医院)临床用血情况,为进一步提高科学合理用血水平提供依据。方法使用成电医星HIS系统收集自治区医院各科室2014~2018年临床用血数据,包括全血及成分血用量、成分血及用血总量;临床用血ABO血型分布;出院人数、手术台次、手术用血;内科与外科临床用血量情况;临床用血的民族分布情况;临床不同种类疾病用量等,做回顾性调查分析。结果 2014~2018自治区医院临床用血总量21 654.5 U,由3 930.5 U上升至4 949 U,年均增长率5.93%;成分血输注率从47.18%提升至99.02%;临床用血总量的血型分布占比依次B型36.4%、O型36.2%、A型20.4%和AB型7.0%;人均用血量年均增长率1.6%,手术台次平均用血量年均增长率-1.9%;内科与外科临床用血科室的历年用血总量比例66.2%,33.8%,重症监护疾病类、血液病类、妇科产科病占本院临床用血总量前3位,占52.4%;藏族、汉族和其他临床用血总量比例分别为:97.52%,2.59%,0.35%。结论自治区医院用血总量逐年上升,开展成分输血比例逐年上升,但临床科学、合理用血仍有待加强。