肿瘤患者凝血检测标本不合格原因分析及对策  

Analysis of reasons for unqualified blood specimens in coagulation test in tumor patients and its countermeasures

作　　者：马莉[1,2] 马晓琴 杨丽[1,2] 

机构地区：[1]云南省肿瘤医院 [2]昆明医科大学第三附属医院检验科,云南昆明650118 [3]云南省中医院风湿科,云南昆明650021

出　　处：《国际检验医学杂志》2015年第18期2694-2696,共3页International Journal of Laboratory Medicine

摘　　要：目的分析肿瘤患者凝血检测不合格标本产生的原因并制订相应对策,确保分析前标本的质量。方法回顾性分析云南省肿瘤医院检验科2012、2013年和2014年第1季度接收的住院患者凝血检测标本各40 253、46 756、14 566份,以不合格率描述不合格标本情况,比较不合格标本分布及变化情况。结果 2012、2013年凝血检测标本的不合格率分别为0.57%和0.96%。2012年标本不合格原因依次为标本凝集、标本量少、标本量多、容器不对及无标本。2013年标本不合格原因依次为标本凝集、标本量少、标本量多、条码错误、标本污染、容器不对、无标本、红细胞比容大于或等于55%、重复送检。结论凝血检测对标本要求高,分析前的质量保证尤为重要,检验科需加强与护理部门和临床之间的联系,及时沟通反馈不合格标本的情况,共同寻找原因并制订和实施切实有效的改善措施,确保分析前环节标本的质量。Objective To analyze reasons for the generation of unqualified blood specimens in coagulation test in tumor patients and to develop countermeasures ,so as to ensure the quality of samples prior to analysis .Methods Blood specimens received from outpatients in Tumor Hospital of Yunnan Province in 2012（40 253 specimens） ,2013（46 756 specimens） and first quarter of 2014 （14 566 specimens）were retrospectively analysed .Unqualified rate was used to describe situation of unqualified specimens ,and the distribution and changes of unqualified specimens were compared among the three years .Results The unqualified rate of blood specimens in coagulation test in 2012 and 2013 was 0 .57% and 0 .96% ,respectively .Reasons for unqualified blood specimens in 2012 was ,in order ,specimens agglutination ,insufficient amount of specimen ,excessive amount of specimen ,wrong container ,no specimen .Reasons for unqualified blood specimens in 2013 was ,in order ,specimens agglutination ,insufficient amount of specimen , excessive amount of specimen ,bar code error ,contaminated specimen ,wrong container ,no specimen ,hematocrit≥55% ,repeated in‐spection .Conclusion Coagulation test requires high quality specimen and quality assurance prior to analysis is particularly impor‐tant .The clinical laboratories should strengthen the links between the nursing and clinical departments ,timely communicate and feedback situation of unqualified specimens ,find the cause together and develop and implement effective improvement measures ,in order to ensure the quality of specimens on the steps before analysis .

关 键 词：不合格标本 分析前环节 质量保证 

分 类 号：R730.43[医药卫生—肿瘤]