患者血液管理的重要性与多学科团队的作用

摘要

临床输血是医疗工作中的重要组成部分，但在临床实践中，存在一定的风险和一定数量的不必要输血行为。患者血液管理（patient-centered blood management，PBM）是一种基于循证医学的多学科协作的治疗策略，在合理优化使用血制品和减少输血相关风险中具有重要作用。由多学科团队制定的PBM方案能减少患者失血，降低患者输血率和改善患者结局。本文从患者贫血管理、优化凝血、多技术手段联合应用及以患者为中心的决策制定四方面阐述PBM的重要性。%Blood transfusion is an important part in themedical treatment, but there remains wide variation in practice, such as some risks and unnecessary blood transfusions. The patient-centered blood management(PBM), which describes an evidence-based, multi-disciplinary therapeutic approach, plays an important role in optimization of blood products and reduction of risks associated with blood transfusion. The PBM made by the multi-disciplinary team(MDT) can provide a management plan which aims at reducing patients’ blood loss and the rate of blood transfusion in the treatment and improving outcomes of the patients. This paper describes the importance of PBM in four aspects including anemia management, coagulation optimization, multi-technology combination and patient-centered decision making.