血气分析自动审核规则的评估与优化  

Evaluation and optimization of autoverification rules for blood gas analysis

作　　者：兰星宇 黄鑫[2] 刘震 杨大干[2] LAN Xingyu;HUANG Xin;LIU Zhen;YANG Dagan(Department of Laboratory Medicine,The First Division Hospital of Xinjiang Production and Construction Group,Akesu 843000,Xinjiang;Department of Laboratory Medicine,The First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,Zhejiang;Hangzhou Tongshuo Information Technology Co.,Ltd.,Hangzhou 311121,Zhejiang,China)

机构地区：[1]新疆生产建设兵团第一师医院检验科,新疆阿克苏843000 [2]浙江大学医学院附属第一医院检验科,杭州310003 [3]杭州同烁信息技术有限公司,杭州311121

出　　处：《临床检验杂志》2022年第7期546-550,共5页Chinese Journal of Clinical Laboratory Science

基　　金：科技创新2030——“新一代人工智能”重大项目(2020AAA0109405)。

摘　　要：目的评估和优化血气分析的审核规则,提高自动审核通过率。方法回顾分析8453份血气标本的自动审核通过率。参考CLSI AUTO-15、CLSI EP33,评估和优化血气项目的限值和差值范围。调整规则并通过验证后,重新计算自动审核通过率。结果血气分析的自动审核原有规则15个项目共64条,自动审核通过率是46.4%。不通过原因差值占22.5%,限值占22.3%。调整差值规则6条,如氧分压差值百分率从“<-130%或>130%”调整为“<-180.6%或>234.3%”。调整限值规则8条,如警戒总氧含量从“<2.5 mmol/L或>20.4 mmol/L”调整为“<4.1 mmol/L或>23.4 mmol/L”。928例验证人工审核和自动审核的符合率100%。规则调整后自动审核通过率是66.2%。结论合理地调整限值和差值范围可提高自动审核的通过率。Objective To evaluate and optimize the autoverification rules for blood gas analysis so as to improve the pass rate of autoverification.Methods The passing rates of 8453 blood gas samples in autoverification(AV)were retrospectively analyzed.The limits and of blood gas items were evaluated and optimized by referring to CLSI AUTO-15 and CLSI EP33.After adjusting the rules,the passing rates of autoverification were recalculated.Results There were 64 rules in 15 items in the original autoverification rules for blood gas analysis.The passing rate of autoverification was only 46.4%.The delta check accounted for 22.5% and the limit value accounted for 22.3% in the failed reasons.Six delta check rules were adjusted,for example,the percentage of delta check for oxygen partial pressure was changed from"<-130 or>130%"to"<-180.6% or>234.3%".Eight limit rules were adjusted,for example,the alert of total oxygen concentration was changed from"<2.5 mmol/L or>20.4 mmol/L"to"<4.1 mmol/L or>23.4 mmol/L".The agreement rate of manual audit with autoverification was 100% in 928 cases.The passing rate of autoverification was 66.2% after the rule adjustment.Conclusion Reasonably adjusting the limits value and delta check range may improve the passing rate of autoverification.

关 键 词：血气分析 自动审核 差值校验 警戒值 

分 类 号：R446[医药卫生—诊断学]