In recent years, with the rapid development of blood transfusion technology, blood transfusion has become an important means of treatment and adjuvant therapy, and an important measure to save lives. Scientific and rational use of blood has become the focus of attention. Article 16 of the Blood Donation Law stipulates that medical institutions should make blood use plans for clinical use, follow the principles of rationality and science, and must not waste or abuse blood. Article 4 of the Technical Specification for Clinical Blood Transfusion stipulates that the blood transfusion department (blood bank) established by medical institutions is mainly responsible for the technical guidance and implementation of clinical blood use, and ensures the implementation of scientific and reasonable blood use measures such as blood storage and blood matching. Therefore, we should strictly follow the scientific and reasonable principle of blood use in clinic, minimize the risk of blood transfusion and improve the safety level of blood transfusion. First, strictly grasp the indications of blood transfusion. Some clinicians don't understand the provisions of the "Technical Specification for Clinical Blood Transfusion" on blood transfusion indications, and only rely on old ideas to give blood transfusion to patients, thinking that blood transfusion can supplement nutrition, enhance physical fitness, improve immunity and make patients recover as soon as possible. Many doctors use plasma to expand volume and supplement albumin. This will not only fail to achieve the expected results, but also make patients suffer from transfusion-transmitted diseases and increase the probability of adverse reactions. According to relevant data, the incidence of adverse reactions of blood transfusion is 0.57%[ 1], among which the incidence of plasma transfusion is the highest. At present, the most common unreasonable blood transfusion in clinic is insurance blood transfusion. Although the clinician can't reach the indication of blood transfusion, considering the ever-changing condition of the patient, in order to be on the safe side, blood transfusion is still given to the patient to reduce the risk caused by insufficient evaluation. Therefore, clinicians should update the knowledge of blood transfusion in time, change the old concept of blood transfusion, and strengthen the study of blood transfusion professional knowledge such as tangible components. Before giving blood transfusion to patients, we should strictly grasp the indications of blood transfusion and make risk assessment. Only when the advantages outweigh the disadvantages and there are no other alternative measures can we consider blood transfusion. This not only saves valuable blood resources, reduces the economic burden of patients, but also avoids the risks brought by blood transfusion. Second, accurately evaluate the amount of blood transfusion Another important issue of reasonable blood transfusion is the amount of blood transfusion. Like clinical medication, only the best dosage can achieve the expected effect, otherwise patients will have side effects without efficacy. Blood transfusion emphasizes this point more. Because when the amount of blood transfusion to patients is not enough, patients will not only fail to achieve the expected curative effect, but also risk contracting transfusion-transmitted diseases and transfusion reactions, the severity of which far exceeds the side effects of drugs.

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Clinically, it is very common for some doctors to give patients blood transfusion 1-2U. Strictly speaking, most of this blood transfusion is unreasonable, or these patients don't need blood transfusion at all, and they can be replaced by iron supplementation, folic acid supplementation or diet (eat more red dates, peanuts, etc.). ). Either these patients have insufficient blood transfusion and cannot achieve the expected curative effect at all. Therefore, accurately evaluate the amount of blood transfusion, and never lose blood that should not be lost. Give a full dose at one time to avoid multiple immunizations of patients and risk multiple infections of transfusion-transmitted diseases and transfusion reactions! Third, we strongly advocate component blood transfusion. Component blood transfusion is an important symbol of modernization of blood transfusion, and it also reflects the level of blood transfusion in a country. Component blood transfusion can not only improve the curative effect and make full use of precious blood resources, but also has the advantages of good curative effect, few side effects and convenient storage and transportation. Some clinicians do not know enough about component blood transfusion. They think that whole blood is better than component blood transfusion, and it can completely supplement various blood components. In fact, the maintenance solution used in whole blood collection is designed to preserve red blood cells, while the activity and physiological function of other components in whole blood, such as platelets, white blood cells, coagulation factors, etc., gradually decrease with the extension of storage time. In addition, transfusion of whole blood will increase the risk of infection. Because if the blood pollutes the virus, the virus is not evenly distributed in all blood components, and some components, such as white blood cells, plasma and viruses, are distributed in many places, which is relatively dangerous. Some components, such as red blood cells, have relatively little virus distribution, so the risk is relatively small. When a patient only needs a certain blood component, especially a blood component with a relatively small risk of virus, this blood transfusion should only be given to the patient. Because if the whole blood is transfused, it means that other components that the patient does not need, including components with relatively high virus risk, are also transfused to the patient, thus increasing the risk of the patient being infected with the virus, and this risk can be completely avoided by component transfusion. Therefore, in order to use blood scientifically and reasonably, the proportion of blood transfusion in hospitals must be increased, and the third-class hospitals must reach more than 80%. In addition, it is necessary to change the deep-rooted traditional concept of clinicians (whole blood transfusion is better than blood transfusion in blood component), so that doctors can fully realize the benefits of blood transfusion in blood component, thus increasing the proportion of blood transfusion in hospitals and improving the safety of blood transfusion. Fourth, carry out autologous blood transfusion technology Autotransfusion refers to a blood transfusion method that collects the patient's own blood under certain conditions and returns it to the patient himself at an appropriate time. Autologous blood transfusion is one of the safest blood transfusion methods for eligible patients, which can avoid adverse reactions such as transfusion-transmitted diseases caused by allogeneic donor blood transfusion. For patients with RH(D) negative and other rare blood group diseases, autologous blood transfusion should be adopted if their own conditions permit. In addition, Article 15 of the Measures for the Administration of Clinical Blood Use in Medical Institutions stipulates that the attending physician should mobilize patients to store blood, autologous blood transfusion or mobilize their relatives and friends to donate blood for patients with flat diagnosis and patients with elective surgery. The development of autologous blood transfusion technology not only saves valuable blood resources, but also alleviates the increasingly tense contradiction between supply and demand of blood sources, avoids the spread of transfusion infectious diseases, reduces the inspection work before blood transfusion (setting and matching blood), and avoids the occurrence of allogeneic blood transfusion accidents. A small amount of blood sampling before operation can also stimulate the production of hematopoietic cells in bone marrow. Autologous blood transfusion is also to solve the blood supply problem of special religious believers who do not accept allogeneic blood transfusion. Autologous blood transfusion is gradually becoming one of the indicators of rational use of blood in clinic. V. Training and Assessment For new recruits, on-the-job staff in the blood transfusion department, clinicians and all nursing staff, publicity and training on scientific and rational use of blood should be strengthened, and assessments should be conducted from time to time, so that everyone can truly understand the "scientific and rational use of blood" and try to reduce unreasonable and unscientific use of blood. To sum up, blood transfusion has become an important measure to treat and rescue patients, but blood transfusion is risky. As a blood worker, we should use blood scientifically and reasonably to minimize the risk of blood transfusion!