住院患者全血细胞分析最适采血量应用研究

Applied research of optimal blood volume of blood cell analysis in hospitalized patients.

目的探讨静脉血采血量对血细胞分析仪检测结果的影响,从而找到最佳采血量减少住院患者的实验室检验性失血。方法 20例健康门诊患者在标准2ml真空定量采血管中分别采0.5、1.0、1.5、2.0ml全血,然后分别在日本Sysmex XE-2100五分类全自动血细胞分析仪第3测试模式(CBC+DIFF)检测结果,比较采血量不足2ml三管检测结果与标准2 ml采血量各组之间的结果。结果全血细胞分析1.0ml、1.5ml采血量与标准2.0ml采血量结果差别无统计学意义。0.5ml采血量各项指标结果均值与2ml采血量结果均值的相对偏差不大,但其不精密度偏高。结论考虑到0.5ml采血量结果不精密度偏高和对异常分析结果需要复查及复检等因素,建议在住院患者特别是新生儿、婴儿和危重患者使用1ml的采血量以减少实验室失血。更重要的是加强医护人员对检验性失血的普遍认识,减少浪费,规范医疗管理。

Objective To accommodate under-filled tubes and reduce blood loss from laboratory testing（BLLT） while optimizing our automation.We explored the acceptable limit of under-filled tubes for hematology values.MethodsWe collected 5.0 ml of blood from 20 normal adult volunteers.Each donation was aliquoted in the following volumes：2.0,1.5,1.0,0.5ml Thesesamples were analyzed within 1h of blood collection on sysmex XE-2100 for complete blood count,reticulocyte and white blood cell differentials.Results of the under-filled tubes were compared to those of the standard volume.ResultsThere was no significant difference for CBC,reticulocytes and WBC differentials when blood was collected with 1.0 or 1.5ml volume in a 2.0 ml spray dried EDTA collection tube compared to a completely filled tube,but the imprecision of 0.5ml was slightly higher.Conclusion For 0.5ml of collection volume,the imprecision was slightly higher.It is very difficult to review and perform peripheral blood smear for the abnormal results.Acceptable complete blood count values of under-filled powdered K2EDTA tubes can be obtained with as little as 1.0ml of blood for hospitalized patients in the ICU and pediatrics ward.More important is the strengthening of health care on the BLLT in general understanding,reduce waste,standard medical management.