血气标本不合格原因分析与分析前的质量控制  

Causes analysis of unqualified arterial blood gas samples and pre-analysis quality control

作　　者：王甩艳 黄涛 卢文深 莫红梅 张秀明 WANG Shuaiyan;HUANG Tao;LU Wenshen;MO Hongmei;ZHANG Xiuming(Department of clinical laboratory,The 3rd Affiliated Hospital of Shenzhen University,Shenzhen 518026,China;Department of clinical laboratory,Shenzhen Children′s Hospital,Shenzhen 518026,China)

机构地区：[1]深圳市罗湖区人民医院医学检验科,518001 [2]深圳市儿童医院检验科,518026

出　　处：《国际检验医学杂志》2017年第A02期107-109,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨血气标本不合格的原因,为制定改进措施提供依据,以提高分析前检验质量。方法回顾性分析本医院2016年8月至2017年7月不合格血气标本的原因和特点,且应用帕累托图要因分析对不合格标本进行分类统计。结果统计分析得不合格标本148份,不合格率为7.58%。不合格标本的原因前3位是:标本为静脉血,标本有凝块和标本有气泡。着重关注影响不合格标本累积比率占80%的科室共有6个,分别为呼吸内科、心血管内科、重症医学科、神经外科、普外科和骨外科,在这6个科室中,不合格率最高的是神经外科,其次是骨外科,第三是心血管内科,不合格率均在10%以上。结论检验科应加强与临床的沟通,且培训护理人员标准化采集标本,以保证检验前的质量,检测出准确的报告,为临床疾病的诊断和治疗提供最可靠的依据。Objective To analyze the causes of unqualified arterial blood-gas samples and provide reference to improve the qualified rate of test samples.Methods The unqualified test samples from August2016to July2017in our hospital were retrospectively analyzed and the countermeasures were developed,were performed the classified statistics by the Pareto chart analytical method.Results Through inspection of samples election,to know the number of unqualified examine samples was148,specimen unqualified rate7.58%.The three main rejection reasons of the unqualified samples were venous blood,the clotted and bubbles.Focused on impact unqualified samples cumulative rate up to80%of departments were six,which were respiratory medicine,cardiovascular internal medicine,intensive care unit,neurosurgery,general surgery and bone surgery.In the six departments,The highest unqualified rate was neurosurgery,followed by bone surgery,and the third was cardiovascular internal medicine,above10%unqualified rate.Conclusion Department of clinical laboratory should strengthen the communication with clinical,and train nursing personnel standard samples taken,to ensure pre-analysis quality and detect the accurate reports.It provided the most reliable evidence for diagnosis and treatment of clinical disease.

关 键 词：动脉血气 不合格标本 分析前的质量控制 

分 类 号：R472.9[医药卫生—护理学]