- 期刊
病人血液管理之經驗分享
Implementation of Patient Blood Management Program in a Medical Center
摘要
近十多年，輸血醫學領域持續提倡「病人血液管理」（patient blood management, PBM），即是藉由實證研究的證據與多學科跨領域專業團隊合作，以科學方法來優化病人輸血的管理。廣義來說病人血液管理需涵蓋病人整個輸血決策過程的評估，包括須遵循血品的輸血指引、提供優質的血品保障輸血安全、透過新的技術減少病人失血量及適當的補充血液容積或藥物等。藉此減少病人非必要性的異體輸血及感染風險；也能同時避免有限血品的浪費，並能降低醫療成本讓血液利用最佳化。本院自101年起，逐步導入各項血液管理措施，包括進行用血適當性審查、人員輸血教育訓練、優化輸血作業資訊流程以及全面改用減除白血球之紅血球濃厚液，並參與台灣血液監測系統，目標希望能以病人為中心減少不必要的輸血，進而節約醫療成本並促進輸血安全。
並列摘要
For more than a decade, transfusion medicine advocates ＂Patient Blood Management＂ (PBM) based on scientific evaluations of blood transfusions. The management assesses the entire blood transfusion processes, including observance of transfusion guidelines, blood quality, and new techniques for reduction of blood loss. These processes are intended to avoid the risk of allogeneic blood transfusion and infection, reduce the waste of blood products and costs of medical care, and optimize blood utilization. Following the principles of PBM, our hospital has implemented various blood management policies since 2012, including blood audit, continuing medical education for transfusion personnel, optimization of blood transfusion information system, comprehensive use of pre-storage leukocyte reduction blood components, and participation in the Taiwan hemovigilance programs. These patient-centered cares not only have reduced unnecessary blood transfusions, but also have improved the quality of medical services and the safety of blood transfusions.