ﻣﺼﺮف ﻓﺮآوردهﻫﺎي ﺧﻮﻧﯽ در زﻧﺎن ﺑﺴﺘﺮي در ﺑﯿﻤﺎرﺳﺘﺎن آﻣﻮزﺷﯽ زﻧﺎن و زاﯾﻤﺎن رﺷﺖ ﻃﯽ ﺳﺎلﻫﺎي 1390 اﻟﯽ 1393

Blood Products Consumption in Women who Admitted at the Obstetrics and Gynecologic Teaching Hospital of Rasht, 2011-2014

زﻣﯿﻨﻪ و ﻫﺪف: ﺑﺎ وﺟﻮد آﻧﮑﻪ ﻣﺼﺮف ﻓﺮاوردهﻫﺎي ﺧﻮﻧﯽ در ﺑﯿﻤﺎران زﻧﺎن و ﻣﺎﻣﺎﯾﯽ ﺣﯿﺎت ﺑﺨﺶ اﺳﺖ، اﺳﺘﻔﺎده ﻏﯿﺮﻣﻨﻄﻘﯽ از آن ﻫﺰﯾﻨﻪ ﺑﺮ ﺑﻮده و ﻣﯽﺗﻮاﻧﺪ ﻃﯿﻔﯽ از ﻋﻮارض ﻧﺎﺧﻮاﺳﺘﻪ را ﺑﻪ دﻧﺒﺎل داﺷﺘﻪ ﺑﺎﺷﺪ. ﻫﺪف اﯾﻦ ﻣﻄﺎﻟﻌﻪ، ﺑﺮرﺳﯽ ﻣﻘﺪار ﻣﺼﺮف ﻓﺮآوردهﻫﺎي ﺧﻮﻧﯽ در ﺑﯿﻤﺎران زﻧﺎن و ﻣﺎﻣﺎﯾﯽ و ارزﯾﺎﺑﯽ ﻣﻘﺪار درﺧﻮاﺳﺖ و ﻣﺼﺮف ﺳﻠﻮل ﻗﺮﻣﺰ ﺧﻮﻧﯽ ﻣﯽﺑﺎﺷﺪ. ﻣﻮاد و روش ﻫﺎ: در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺗﻮﺻﯿﻔﯽ و ﮔﺬﺷﺘﻪﻧﮕﺮ، از اﺑﺘﺪاي ﻓﺮوردﯾﻦ 1390 ﺗﺎ اﺑﺘﺪاي ﻓﺮوردﯾﻦ 1393، وﺿﻌﯿﺖ ﻣﺼﺮف ﻓﺮآوردهﻫﺎي ﺧﻮﻧﯽ در 1214 زن ﺑﺴﺘﺮي در ﺑﯿﻤﺎرﺳﺘﺎن آﻣﻮزﺷﯽ زﻧﺎن و زاﯾﻤﺎن اﻟﺰﻫﺮا )س( رﺷﺖ ﺗﺤﺖ ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺖ. اﻃﻼﻋﺎت ﺟﻤﻊآوري ﺷﺪه ﺷﺎﻣﻞ ﻣﺸﺨﺼﺎت زﻣﯿﻨﻪاي زﻧﺎن، ﻋﻠﺖ ﺑﺴﺘﺮي، ﻫﻤﻮﮔﻠﻮﺑﯿﻦ و ﻫﻤﺎﺗﻮﮐﺮﯾﺖ ﭘﯿﺶ از ﺗﺰرﯾﻖ ﺧﻮن و ﻧﻮع و ﺗﻌﺪاد ﻓﺮآورده ﺧﻮﻧﯽ ﺗﺰرﯾﻖ ﺷﺪه ﺑﺎ ﻧﺮم اﻓﺰار SPSS ﻧﺴﺨﻪ19 ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﮔﺮدﯾﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: از ﻣﺠﻤﻮع 10824 واﺣﺪ ﺳﻠﻮل ﻗﺮﻣﺰ ﺧﻮﻧﯽ درﺧﻮاﺳﺖ و ﮐﺮاس ﻣﭻ ﺷﺪه، ﺗﻨﻬﺎ 2804 واﺣﺪ آن )26%( ﺑﻪ ﺑﯿﻤﺎران ﺗﺰرﯾﻖ ﮔﺮدﯾﺪ. ﻧﺴﺒﺖ ﮐﺮاس ﻣﭻ ﺑﻪ ﺗﺰرﯾﻖ ﺳﻠﻮل ﻗﺮﻣﺰ ﺧﻮﻧﯽ، 3/9 ﺑﻮده و ﻣﯿﺎﻧﮕﯿﻦ ﻫﻤﻮﮔﻠﻮﺑﯿﻦ و ﻫﻤﺎﺗﻮﮐﺮﯾﺖ ﭘﯿﺶ از درﯾﺎﻓﺖ ﺳﻠﻮل ﻗﺮﻣﺰ ﺧﻮﻧﯽ در ﺑﯿﻤﺎران ﺑﻪ ﺗﺮﺗﯿﺐ G/DL 1/7 ± 8/3 و % 4/8 ± 27/4 ﮔﺰارش ﺷﺪ. 25 درﺻﺪ ﺑﯿﻤﺎران ﺗﻨﻬﺎ ﯾﮏ واﺣﺪ ﺳﻠﻮل ﻗﺮﻣﺰ ﺧﻮﻧﯽ درﯾﺎﻓﺖ ﻧﻤﻮدﻧﺪ. ﻧﺘﯿﺠﻪ ﮔﯿـﺮي: ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﺑﺎﻻ ﺑﻮدن ﻧﺴﺒﺖ ﮐﺮاس ﻣﭻ ﺑﻪ ﺗﺰرﯾﻖ ﺧﻮن و ﺷﺎﺧﺺﻫﺎي ﺧﻮﻧﯽ ﺗﺰرﯾﻖ ﺳﻠﻮل ﻗﺮﻣﺰ ﺧﻮﻧﯽ، ﺑﻪ ﻧﻈﺮ ﻣﯽرﺳﺪ ﮐﻪ درﺧﻮاﺳﺖ و ﻣﺼﺮف ﻓﺮآوردهﻫﺎي ﺧﻮﻧﯽ ﺑﯿﺶ از ﻣﻘﺪار ﻻزم اﻧﺠﺎم ﮔﺮﻓﺘﻪ و ﺑﺮرﺳﯽ دﻗﯿﻖﺗﺮ ﻋﻠﻞ آن ﺟﻬﺖ اراﺋﻪ راﻫﮑﺎرﻫﺎي ﺑﺎﻟﯿﻨﯽ ﻣﻨﺎﺳﺐ ﺿﺮوري ﺑﻪ ﻧﻈﺮ ﻣﯽرﺳﺪ.

Introduction & Objective: Although blood transfusion is life saving for obstetric and gynecologic patients, it is costly and can result in series of adverse reactions if transfusion not done rationally. The aim of this study was to evaluate blood products consumption in obstetrics and gynecologic patients and measurement of Crossmatching to Transfusion (C/T) ratio. Materials & Methods: This was a retrospective descriptive study conducted among 1214 women who receive blood products at the Al-Zahra teaching hospital in Rasht, during the 3 years period from March 2011 to March 2014. The collected data include demographic data, cause of admission, before transfusion hemoglobin and hematocrit and number and type of transfused blood products were analyzed with SPSS version 19. Results: Only twenty-six percent (2804) of requested and cross matched blood products (10824) transfused. Crossmatching to Transfusion (C/T) ratio was 3.9 and Hemoglobin and hematocrit mean values before Red Cell Concentrate (RCC) transfusion were 8.3 ± 1.7 g/dL and 27.4 ± 4.8 % respectively. 25 percent of patients received only one unit of RCC. Conclusions: Due to high C/T ratio and RCC transfusion indexes, it seems that requisition and consumption of blood products are exceed the necessary amount and it seems essential to evaluate its causes accurately to provide appropriate clinical practice guidelines.