全自动血型仪判读无效结果的原因分析  

Invalid results analysis of full-automatic blood typing instrument

作　　者：金新莉[1] 李丹[1] 刘湘巧 马晓莉[1] 方建华[1] JIN Xinli;LI Dan;LIU Xiangqiao;MA Xiaoli;FANG Jianhua(Department of Laboratory,Henan Red Cross Blood Center,Zhengzhou,450012,China)

机构地区：[1]河南省红十字血液中心检验科,郑州450012

出　　处：《临床血液学杂志（输血与检验）》2018年第5期781-783,共3页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

基　　金：2015年度河南省医学科技攻关计划项目(No:201503199)

摘　　要：目的:提高全自动血型仪献血者初筛血型检测结果的准确性,分析在使用过程中遇到的判读无效结果的原因,制定应对策略。方法:收集伽利略血型仪对2016-08—2017-07献血者标本210 055份进行ABO、Rh(D)血型检测,对血型仪判读无效的结果进行分析。通过试管法复查或送至中心血型研究室进行最终血型确认。结果:一次判读正确的标本208 785份(99.4%),判读无效的标本1 270份(0.6%),经血型研究室确认78份ABO正反定型不符的标本中包括冷抗体5份(6.4%)、特异性抗体19份(24.4%)、抗原减弱20份(25.6%)、抗体减弱34份(43.6%);其余1 192份无法判读结果的标本中根据ABO、Rh检测过程中出现的情况分为灰区127份(10.7%)、96份(8.1%);未加上样本376份(31.5%)、376份(31.5%);阴性质控结果异常325份(27.3%)、325份(27.3%);脂血90份(7.5%)、0份(0);污染149份(12.5%)、5份(0.4%);未加上试剂8份(0.7%)、16份(1.3%)。结论:全自动血型仪操作简便,检测结果能长时间保存,易于追溯。对于判读无效的结果结合手工试管法可提供高效准确的检验结果,确保临床用血安全。Objective：To investigate the accuracy of full-automated blood typing instrument in the identification of blood types,and analyze the causes of invalid results in our tests and then formulate appropriate strategies.Method：From August 2016 to July 2017,210 055 blood samples were submitted to ABO and Rh（D）identification by GALILEO NEO full-automatic blood typing instrument.The samples of invalid results were reexamined by the tube method or were sent to blood typing laboratory for confirmation and the reasons were analyzed.Result：208 785（99.4%）were correctly identified,and 1 270（0.6%）were invalid.There were 78 specimens that were confirmed by the blood type research room as inconsistent with positive and negative ABO stereotypes,and among them,5 cases（6.4%）of cold antibodies,19 cases（24.4%）of specific antibodies,20 cases（25.6%）of weakened antigens,and 34 cases（43.6%）of weakened antibodies.According to ABO and RH tests,the remaining 1,192 specimens that could not be interpreted were divided into two groups.The causes of first group were 127 cases（10.7%）grey areas,376 cases（31.5%）not added to the sample,325 cases（27.3%）Abnormal results of negative quality control,90 cases（7.5%）Lipid blood,149 cases of pollution（12.5%）,8 cases（0.7%）reagents not added.The corresponding reasons for the second groups were 96 cases（8.1%）,376 cases（31.5%）,325 cases（27.3%）,0 cases（0）,5 cases（0.4%）,16 cases（1.3%）.Conclusion：The full-automatic blood typing instrument was convenient operation,the test results can be preserved for a long time,easy to trace.The results of invalid interpretation combined with manual test tube method can provide efficient and accurate test results to ensure the safety of clinical blood use.

关 键 词：全自动血型仪 无效结果 血液安全 

分 类 号：R457.1[医药卫生—治疗学]