Abstract: Objective To establish and apply the heterotypic blood transfusion mode for patients with incompatible blood transfusion after allogeneic hematopoietic stem cell transplantation.Methods A retrospective analysis was conducted on 993 cases of heterotypic blood transfusion in our department from 2015 to 2017. We established a working group on heterotypic blood transfusion. From March to August 2018,based on the characteristics of heterotypic blood transfusion,the steps of heterotypic blood transfusion were refined on the basis of transforming the working mode of homotypic blood transfusion,and the program of improving nursing workflow of heterotypic blood transfusion was constructed. It was implemented in nurses of hematology ward and changed weekly according to feedback.Results After the construction and practice of allogeneic hematopoietic stem cell transplantation in patients with blood incompatibility,the incidence of distribution error（P<0.01）,medical order error（P<0.01） and transfusion reaction（P<0.05） were significantly reduced.Conclusion The safe and efficient operating mode of heterotypic blood transfusion not only improves the nursing efficiency,but also prevents the occurrence of nursing errors,which is worthy of reference and promotion.

Key words: Blood Group Incompatibility, Stem Cell Transplantation, Heterotypic Blood Transfusion, Operating Mode, Hematologic Diseases, Nursing Care

摘要： 目的 构建与实践异基因造血干细胞移植后患者异型输血工作模式。方法 对温州市某三级甲等医院血液科2015年—2017年993例异型输血病例进行回顾性分析,成立异型输血工作小组,2018年3月—8月根据异型输血的特点,在变革同型输血工作模式的基础上,细化异型输血的步骤,构建阶段式异型输血护理工作流程,在血液科病房中实施,每周根据反馈改进,直至完善。结果 异基因造血干细胞移植后患者异型输血工作模式构建与实践后,配送错误、医嘱错误和输血反应的发生例数均明显减少,差异均具有统计学意义（均P<0.05）。结论 异基因造血干细胞移植后患者异型输血工作模式安全高效,不仅提高了护理工作效率,还防止了护理差错的发生,是针对异型输血的有效模式,可为临床护理实践提供借鉴。

关键词: 血型不合, 造血干细胞移植, 异型输血, 工作模式, 血液病, 护理