临床常规生化检验结果的影响因素分析

Analysis of the Influencing Factors of Clinical Routine Biochemical Test Results

目的：探讨临床常规生化检验结果的影响因素,并提出相应的预防对策。方法：回顾性分析2012年2月~2013年2月我院检验科进行的生化常规检测10256例次的检查结果,采用美国BIORAD公司生化定值多项3水平质控品于检测前、中、后进行质控分析,对产生偏差的原因按实验前、实验中、实验后进行归类总结。结果：84例经复核出现超过10%以上偏差,占总分析例数的0.82%。实验前不良事件是产生实验结果偏差的主要因素,占总体产生偏差例数的78.57%,其中患者因素与标本处理不当构成了实验前干扰因素的主体,分别占实验前因素的39.39%和36.36%。不明原因溶血与标本采集方法不当也是实验前的实验干扰因素。实验中影响检测结果的因素主要为仪器故障、试剂过期和失效、定标品或定标曲线过期,分别占实验中因素的46.67%、33.33%、20%。实验后干扰因素均为审核不及时或不细致导致的检测报告不合格。结论：在进行临床常规生化检查的过程中,任何一个环节出现失误均有可能对检查结果造成影响,特别是患者因素、标本采集方法不当及处理不当,均应该引起医护人员的重视。

Objective： To explore the influencing factors of clinical routine biochemical test results, and put forward corresponding preventive countermeasure. Methods： A retrospective analysis was carried out for the biochemical detection test results of 10256 hospitalized cases from February, 2012 to February, 2013. Three levels quality fix value products of American BIORAD company were detected before the test, during the test and after the test to find analysis fault. The causes of error were classified as the source of produced in the biochemical detection test, just as the error before the test, during the test and after the test. Results： 84 error cases which had been re-checked in all test results were found and the deviations were more than 10% than their real value. It accounted for 0.82% of the total analysis cases. The main errors happened before experiment process which accounted for 78.57% of the overall produces deviation. Factors of patients and the specimens misconduct constituted the main body of before the experiment process interference factors, accounted for 39.39% and 36.36% of the errors factors from before the experiment process. Unknown cause hemolysis and improper specimen collection method were also the errors reasons which caused before the experiment interference. Instrument failure,reagent expiration or expired, calibration or calibration curve expired respectively accounted for 46.67%, 33.33%, 20% of experiment factors. After the experiment interference factors were test reports disqualifications which were caused by results checked carelessly or not in time. Conclusion： In clinical routine biochemical examination process, any link wrong could affect the results, especially the patient factors, improper specimen collection method and improper handling. The medical staffs should pay attention to these causes.