肿瘤患者血液标本不合格原因分析

Analysis of the Causes of the Unsuitable Blood Samples in Tumor Patients

目的探讨肿瘤患者血液标本不合格的产生原因并提出解决对策。方法对2010-01—2011-12所收到的肿瘤患者379991个血液检验标本中不合格标本类型及拒收原因进行回顾性调查和分析。结果563个不合格标本，占标本总量的0．15％，以血沉标本不合格率最高（1．65％），其次为凝血标本（0．31％），生化标本不合格率最低。其中标本有凝块是造成拒收的主要原因，占52．22％，其次为标本量过少（22．38％）、输液稀释（6．93％）以及容器不符（4．62％）等。结论分析前的质量保证主要是由临床医护人员完成的环节，实验室和临床之间有效的配合与沟通，是改善标本分析前质量的主要和重要的手段。

Objective To investigate and analyze of the causes of unsuitable blood samples drawn from tumor patients. Methods From January 2010 to December 2011, a total of 379,991 blood specimens were received in our la- boratory. The frequencies and types of cause of rejection samples were retrospectively evaluated. Results We find that 563 unqualified specimen because of poor quality control of preanalysis account for 0.15 % of total blood count specimen. ESR（erythrocyte sedimentation rate） samples had the highest rejection rate of 1.65 %. The second were thrombotest samples（ 0. 31 % ）. The last were biochemical samples. Clot was found to be the major cause of rejection of samples, 52.22 %, followed by insufficient sample volum, dilution by transfusion and incorrect container which gave a rejection rate of 22.38%,6.93% and 4.62% respectively. Conclusion The quality control of preanalysis is the first step of total quality assurance of laboratory data and completed by the physicians and nurses. Therefore, the improvement of preanalysis quality control depends on the cooperation between the technologists and physicians and nurses.