血细胞形态学室间质量评价体系的建立及运行  

Establishment and operation of external quality assessment system for blood cell morphology

作　　者：宋颖博[1] 蒋菲[1] 张艳[1] 董清清[1] 张新[1] SONG Yingbo;JIANG Fei;ZHANG Yan;DONG Qingqing;ZHANG Xin(Center for Clinical Laboratory of Xinjiang Production and Construction Corps/Department of Clinical Laboratory,Hospital of Xinjiang Production and Construction Corps,Urumqi,Xinjiang 830002,China)

机构地区：[1]新疆生产建设兵团临床检验中心/新疆生产建设兵团医院检验科,新疆乌鲁木齐830002

出　　处：《检验医学与临床》2024年第7期865-869,共5页Laboratory Medicine and Clinic

基　　金：国家临床重点专科建设项目(兵财社〔2023〕16号);兵团医学检验临床医学研究中心建设项目(兵科发〔2023〕12号)。

摘　　要：目的建立血细胞形态学室间质量评价(EQA)体系,对基层医院检验人员细胞形态识别能力进行评价。方法新疆生产建设兵团临床检验中心采用图文摄像系统挑选外周血涂片中具有代表性的细胞或物质图片建立血细胞形态学图谱库,结合EQA管理网络平台构建血细胞形态学EQA体系,并开展2023年160余家基层医院血细胞形态学两次共20幅质量评价(质评)图片的EQA工作。结果构建的图谱库涵盖78类各种血细胞,共1520幅图片,包括红细胞系、粒细胞系、淋巴细胞和浆细胞、单核细胞系、巨核细胞和血小板系。2023年血细胞形态学EQA工作通过EQA管理网络平台进行了数据上报、质评成绩发布及汇总分析等。两次EQA均取得满分成绩的实验室数为27家(16.67%),第1次和第2次合格实验室数分别为123家(75.46%)和138家(85.18%),两次合格率比较,差异有统计学意义(P<0.05)。结论该研究构建了较完善的血细胞形态学EQA体系,并在基层医院检验人员细胞形态识别能力的评价中得到了较好的运行,同时也反映出基层医院检验人员血细胞形态识别能力亟待提升。Objective To establish an external quality assessment(EQA)system for blood cell morphology,and to evaluate the cell morphology recognition capability of laboratory personnel in primary hospitals.Methods The typical and representative pictures of cells or substances in peripheral blood smears were selected by the graphic imaging system to establish the blood cell morphology atlas database,the EQA system of blood cell morphology was constructed by combining with EQA management network platform,and the twice EQA works of blood cell morphology,a total of 20 quality evaluation pictures,were carried out in more than 160 basic hospitals of Center for Clinical Laboratory of Xinjiang Production and Construction Corps during 2023.Results The constructed atlas library covered 78 types of blood cells with a total of 1520 images,including the red blood cell system,granulocyte system,lymphocytes and plasma cells,monocyte system,megakaryocytes and platelets,etc.The EQA work of blood cell morphology in 2023 conducted the data reporting,quality evaluation results release,summary analysis,etc.There were 27 laboratories(16.67%)achieving the full marks in the twice EQA works.The number of laboratories that passed the first and second EQA was 123(75.46%)and 138(85.18%)respectively,and the difference between the two qualified rates was statistically significant(P<0.05).Conclusion The more perfect EQA system for blood cell morphology has been constructed by this study and was better applied in the evaluation of cell morphology recognition capability of the inspectors in the basic hospitals.Meanwhile,it also reflects the urgent need to improve the blood cell morphology recognition ability of laboratory personnel in primary hospitals.

关 键 词：血细胞形态学 室间质量评价 图谱库 能力验证 基层实验室 

分 类 号：R446.113[医药卫生—诊断学]