临床微生物实验室数据管理专家系统的建立及应用  

Construction and application of clinical microbiology laboratory data management expert system

作　　者：林雪峰[1] 应华永[2] 陈晓军[1] 江丹英 王兵勇[1] 陈静[1] 

机构地区：[1]温州医科大学附属乐清医院检验科,浙江乐清325600 [2]浙江省金华市中心医院检验科,321000

出　　处：《中华临床感染病杂志》2016年第2期161-167,共7页Chinese Journal of Clinical Infectious Diseases

基　　金：浙江省公益性技术应用研究计划项目（2012C33023）;温州市科技局基金项目（Y20140436）

摘　　要：目的：介绍临床微生物实验室数据管理专家系统的建立及应用。方法对临床微生物实验室进行流程管理，通过对实验室工作流程各节点数据的特征进行分析，建立SQL Server数据表格以构建专家系统知识库，再采用VB6．0语言编写知识获取模块、推理机模块和输入输出接口程序，最终建立专家系统。同时，对应用专家系统前后2年的报告单缺陷率、细菌鉴定及药敏试验上机操作错误率、细菌培养报告延期率以及平均延期时间进行比较分析。结果专家系统可以对样本接收、样本信息采集及输入、细菌培养的培养基选择、细菌鉴定及药敏操作、药敏结果判读、细菌鉴定与药敏结果综合评价、阴性结果报告、阳性结果报告、血培养管理、支原体培养、样本检验时限管理、医院感染指标管理等12个流程节点上的数据进行管理。采用专家系统进行数据管理后，未发现内容有缺陷的报告单，细菌鉴定及药敏试验中上机板条选择错误率从2012年的0．81％（31／3836）降至2014年的0．02％（1／5433），细菌培养报告延期率从1．78％（320／17983）降至1．18％（232／19692），平均延期时间从3．8 d降至3．2 d。结论临床微生物实验室数据管理专家系统可以提高实验室工作效率并减少差错，提高实验室的整体管理水平和提升临床服务的质量。Objective To introduce the construction and application of clinical microbiology laboratory data management expert system.Methods Firstly, the process management was introduced to clinical microbiology laboratory. Then the characteristics of data on each node of work process were analyzed, and SQL Server data table was created as the knowledge base of the expert system.Finally, VB6.0 was used to compile the knowledge acquisition module, reasoning desktop module and input/output interface procedures to finally construct the expert system.Rates of defect report, errors in bacterial identification and drug sensitivity test, delay in culture results reporting and average delayed days were compared before and after the application of the expert system.Results The expert system could be used for data management in process nodes like sample reception, information collection and input, bacteria culture medium selection, bacterial identification and drug sensitive test, interpretation of drug sensitivity results, comprehensive evaluation in bacterial identification and drug sensitivity results, report of negative result, report of positive result, blood culture, Mycoplasma culture, time limit of detection, and nosocomial＆amp;nbsp;infection indicators.No defect report was found after the application of expert system; rate of errors in selection of drug sensitivity test medium was reduced from 0.81% （ 31/3 836 ） in 2012 to 0.02%（1/5 433） in 2014;rate of delay in culture results reporting was reduced from 1.78% （320/17 983） to 1.18%（232/19 692）, and the average delayed days was also reduced （3.8 d vs.3.2 d）.Conclusion Clinical microbiology laboratory data management expert system can improve work efficiency and reduce errors, which can enhance the overall management of laboratory and the quality of clinical service.

关 键 词：临床微生物实验室 专家系统 数据库 

分 类 号：R446.5[医药卫生—诊断学]