北京地区成人危急值界限值分布情况的调查研究  

Investigation on the distribution of critical value limits in adult patients in Beijing

作　　者：王丹[1] 王清涛 郭健 何美懿 周睿[4] 高华英 梁玉芳[4] 左畅[4] 尹弘毅[4] 

机构地区：[1]航空总医院检验科,100012 [2]北京市I临床检验中心 [3]北京市医学检验质量控制和改进中心 [4]首都医科大学附属北京朝阳医院检验科

出　　处：《中华检验医学杂志》2016年第3期181-186,共6页Chinese Journal of Laboratory Medicine

基　　金：国家临床重点专科建设项目;北京医院协会研究项目

摘　　要：目的调查北京地区成人危急值界限值的分布情况，为制定区域性《检验危急值规范化管理技术指南》提供依据，从而推进检验危急值精准管理。方法收集北京地区2015年1月1日至5月31日期间三级及以上医疗机构检验科临检血液、临床生化、凝血、血气项目的出现危急值的病例记录共110398条，将各危急值项目按患者就诊科室、主要诊断作为筛选条件，采用Kruskal—Walis检验，两两比较各组差异性。再将合并后通用组按性别作为筛选条件，采用Mann—Whithey U检验，比较各组的差异性，最终确定危急值分层界限值。结果除ca上限、Glu下限、pCO2上限、pH上下限、Hb上限外，其余各危急值项目均因患者就诊科室／主诊断不同及或性别不同而使危急值界限值差异有统计学意义。结论根据不同就诊科室／疾病类型、性别制定了对各危急值项目的分层界限值。Objective To investigate the distribution of critical values of adults in Beijing, to provide the evidence for the formulation of the Standardized Management Guideline in Critical Values, in order to promote the accurate management of critical values. Methods A total of 110 398 data of critical values from the tertiary and above medical institutions during January 1 to May 31 in 2015 in Beijing were collected by the way of on-site inspection, covering the disciplines of hematology, clinical chemistry, coagulation and blood gas analysis. Fristly, the selected critical values were classified by the factor of admission departments and disease types, then were analyzed by using Kruskal-Wallis test, to compare the differences in each group. Secondly, the combined groups were classified by the factor of gender then were analyzed by using Mann-Whithey U test, to compare the differences in each group. Finally, the stratification thresholds of critical values were established. Results Except for the upper limits of Ca, pH, pCO2, Hb and the lower limits of Glu, pH, the rest of thresholds of critical values had significant differences due to different admission departments and disease types and/or gender. Conclusion Depending on the different admission departmentsces disease types and/or gender, hierarchical limit values on each critical value were formulated.

关 键 词：血液学试验 临床化学试验 血液凝固试验 血气分析 试验预期值 

分 类 号：R446[医药卫生—诊断学]