不合格标本原因分析及改进措施  

Cause analysis of unqualified samples and improvement measures

作　　者：曹楠婧 李娜 罗孟柯 吕海丽 王九菊 CAO Nanjing;LI Na;LUO Mengke;LYU Haili;WANG Jiuju(Department of Clinical Laboratory,the Daxing Hospital of Xi′an,Xi′an,Shaanxi 710000,China)

机构地区：[1]西安大兴医院检验科,陕西西安710000

出　　处：《检验医学与临床》2023年第S02期35-38,共4页Laboratory Medicine and Clinic

基　　金：急救与创伤研究教育部重点实验室2022年开放基金支持项目(KLET-202211)。

摘　　要：目的对该院检验科所接收的不合格血液标本原因及科室分布情况进行分析,探讨并制定改进措施,提高标本的送检质量,为临床提供及时且准确的检测结果。方法回顾性分析该院检验科2020年1月至2022年12月所有不合格标本共2428例,根据《临床实验室质量指标:WS/T 496-2017》中的分析前质量指标对血液标本不合格率进行统计,比较3年间不合格血液标本原因及科室分布情况,并制定相关措施加以规范。结果2020年1月至2022年12月血液标本不合格率为0.13%,其中抗凝血标本凝集34.02%(826/2428)、标本溶血30.43%(739/2428)及标本类型错误17.26%(419/2428)是造成标本不合格的主要原因。在所有临床科室中,ICU、儿科及新生儿科因患者群体特殊,不合格标本率位列前三。结论标本采集是检验前质量控制最主要的环节,通过分析实验室不合格标本的组成及潜在原因,优化标本采集和运输流程,加强标本质量监管,是提高标本送检质量,保证检验结果准确性的关键所在。Objective To analyze the causes and departments distribution of unqualified blood samples received by the laboratory,explore and develop improvement measures to improve the quality of sample submission and provide timely and accurate testing results for clinical practice.Methods A retrospective analysis was conducted on a total of 2428 unqualified blood samples from the laboratory of the hospital from January 2020 to December 2022.According to the pre analysis quality indicators in"Clinical Laboratory Quality Indicators:WS/T 496-2017",the unqualified rate of blood samples was statistically analyzed.The reasons for unqualified blood samples over the past three years and the distribution of departments were compared,and relevant measures were formulated to standardize them.Results The unqualified rate of blood samples in the hospital from January 2020 to February 2022 was 0.13%,among which 34.02%(826/2428)of anticoagulant samples were agglutinated,30.43%(739/2428)of sample hemolysis,and 17.26%(419/2428)of sample type errors were the main reasons for the unqualified samples.Among all clinical departments,ICU,pediatrics and neonatal departments rank among the top three in terms of unqualified sample rates due to their unique patient population.Conclusion Specimen collection is the most important aspect of quality control before testing.By analyzing the composition and potential causes of unqualified specimens in the laboratory,optimizing the process of specimen collection and transportation,and strengthening specimen quality supervision,it is crucial to improve the quality of specimen submission and ensure the accuracy of test results.

关 键 词：质量指标 检验前过程 不合格标本 

分 类 号：R446.1[医药卫生—诊断学]