贵阳市主要临床实验室常规用生理盐水质量调查  

Investigation of quality of routine normal saline from main clinical laboratories in Guiyang

作　　者：安邦权[1] 凌晓午[1] 周湘红[1] 黄盛文[1] 许健[2] 冯宗彪[3] 曾强武[1] 苏莉[1] 杨怀[4] 

机构地区：[1]贵州省人民医院检验科,贵州贵阳550002 [2]贵州省临床检验中心,贵州贵阳550002 [3]贵阳医学院检验系,贵州贵阳550004 [4]贵州省人民医院感染管理科,贵州贵阳550002

出　　处：《中华医院感染学杂志》2011年第15期3191-3194,共4页Chinese Journal of Nosocomiology

基　　金：贵州省科学技术基金项目(黔科合J字[2009]2168)

摘　　要：目的通过对贵阳市主要临床实验室常规用生理盐水有形成分定期调查,督促确保生理盐水干净、无污染,从而提高悬浮法白带和大便常规检测准确性。方法用干净的吸管来回吸打生理盐水瓶中的生理盐水数次,然后取一滴于洁净的玻片上,涂抹均匀后直接镜检;另取8~10 ml生理盐水于洁净的试管内离心后去上清液,管底留0.2 ml,按上法涂片镜检。结果在13所医院中的14个临床实验室常规用生理盐水首次（1997年）质量调研中,离心涂片镜检的真菌污染,污染率为100.00%,滴虫污染率为21.43%;直接涂片镜检有11个实验室发现真菌,2个发现滴虫;之后,生理盐水中的有形成分（真菌、滴虫等病原体和杂质）逐年减少,2007年无一所医院生理盐水发现病原体;在13次调查中,直接涂片和离心沉渣涂片的真菌污染率均差异有统计学意义（P〈0.01）,离心沉渣涂片的滴虫污染率差异有统计学意义（P〈0.05）。结论生理盐水的质量问题直接关系到悬浮法白带常规和大便常规检测结果的准确性和可靠性,以类似室间质量评介（EQA）的形式对实验室常规用生理盐水的质量进行调查和监督,可有效地提高实验室的生理盐水质量和检验人员的质量意识。OBJECTIVE To improve the accuracy of suspension method for leucorrhea and stool routine test by periodical examination of the formed elements in routine normal saline（NS） and supervise the clinical laboratory to ensure the NS be clean.METHODS NS in bottle was absorbed back and forth for several times by a clean pipette,then a drop of NS was taken to a clean glass slide and been smeared evenly for test under microscopy.Another 8 ~ 10ml NS was taken into a clean test tube for centrifugation,and the supernatant liquid was discarded,0.2ml sediment was tested under microscopy by the method mentioned before.RESULTS The results of the first investigation in 1997 showed that when the NS from 14 clinical laboratories of 13 hospitals was tested using the smear of sediment,all of the N.S samples were stained by fungus,the fungus contamination rate was 100.00%,and the infusorian contamination rate was 21.43%.When NS was tested directly by smeared on glass slide,fungus was detected in 11 laboratories,infusorian was detected in 2 laboratories,and more than one ＂＋＂ impurity was detected in 1 laboratory.From then on,formed elements（pathogens such as fungus and infusorian,impurities） were decreased year by year.In 2007,no pathogens were detected in NS from all laboratories.Among the 13 investigations,the contamination rates acquired from the results of direct smear and sediment smear have significant difference（P0.01）,and the infusorian contamination rates acquired from the results of sediment smear also have significant difference（P0.05）.CONCLUSION The quality of NS is directly associated with the accuracy and reliability of suspension method for leucorrhea and stool routine test results.Investigation and supervision the quality of NS in the clinical laboratory by the strategy similar to Exfernal quality assessment（EQA） can effectively improve their quality of NS and the quality awareness.

关 键 词：临床实验室 生理盐水 真菌 滴虫 质量控制 

分 类 号：R446[医药卫生—诊断学]