凝血试验自动审核方案的建立与临床应用  

Establishment and clinical application of an autoverification system for coagulation test

作　　者：李玲[1] 杜佳 赵耿生[1] 伍焕友 沈阳 张李涛[1] 刘晓辉[1] 郭保旭 毛政 杨军[1] 张真路[1] 范庆坤[1] LI Ling;DU Jia;ZHAO Gengsheng;WU Huanyou;SHEN Yang;ZHANG Litao;LIU Xiaohui;GUO Baoxu;MAO Zheng;YANG Jun;ZHANG Zhenlu;Fan Qingkun(Department of Laboratory Medicine,Wuhan Asia Heart Hospital,Wuhan 430021;Wuhan Wallason Software Company Limited,Wuhan 430070;Werfen Medical Device Trading(Beijing)Company Limited,Beijing 100015,China)

机构地区：[1]武汉亚洲心脏病医院检验医学中心,武汉430022 [2]武汉华莱信软件有限公司,武汉430070 [3]沃芬医疗器械商贸(北京)有限公司,北京100015

出　　处：《临床检验杂志》2021年第7期534-538,共5页Chinese Journal of Clinical Laboratory Science

摘　　要：目的建立凝血试验自动审核方案,验证并应用于常规凝血检验。方法采用实验室信息管理系统(LIS)、检测设备和中间软件联合构建自动审核实施方案。采用数据库模拟运行和人工审核的方式对历史检验报告进行自动审核规则验证。评估实施凝血自动审核方案后与人工审核之间实验室内周转时间(TAT)情况。结果构建的自动审核方案涉及9项凝血检验项目,在LIS中设计了13条自动审核规则。在2018年12月至2019年11月期间临床实践应用中,98.86%的检验报告执行了自动审核程序,检验报告自动审核通过率为73.66%,26.34%检验报告被系统拦截后人工审核。凝血检验单项平均通过率为89.26%,其中PT通过率(97.75%)最高,D-dimer通过率(69.38%)最低。实施自动审核后的实验室内TAT中位数和第90百分位值分别较未自动审核时缩短5 min和15 min。实施自动审核期间,自动审核的凝血检验报告TAT的中位数和第90百分位值较人工审核分别缩短22 min和27 min。结论构建的自动审核方案在临床实施后可缩短实验室内TAT,提高工作效率。Objective To establish an autoverification system program for coagulation tests and apply it for checking the results of rou-tine coagulation tests.Method A performance scheme of autoverification system was established by laboratory information system(LIS),testing equipments and middlewares.The historical results of laboratory were verified for automatic review rules by both data-base simulation operation and manual review.The difference of laboratory turnaround time(TAT)between autoverification program and manual audit was evaluated.Results The established automatic audit program involves 9 coagulation test items,and 13 automatic au-dit rules were designed in LIS system.In the application of clinical practice from December 2018 to November 2019,automatic audit procedure were performed in 98.86%of the laboratory results an with pass rate of automatic audit procedure were performed in 98.86%of the laboratory reports,and the residual 26.34%were manually reviewed after being intercepted by the automatic audit system.The average pass rate of single item in coagulation tests was 89.26%,among which the pass rate of PT(97.75%)was the highest and D-dimer(69.38%)was the lowest.Following the automatic audit the median TAT and the value of the 90th percentile in the laboratories were shortened by 5 minutes and 15 minutes,respectively,compared with those without automatic audit.During the implementation of the automatic audit,the median and 90th percentile values of TAT were shortened by 22 min and 27 min,respectively,compared with manual audit.Conclusions The automatic audit program established in this study may shorten the TAT in laboratories and improve the work efficienc.

关 键 词：自动审核 实验室信息系统 周转时间 凝血试验 

分 类 号：R446[医药卫生—诊断学]