随机盲样检测在临床血液学室间质量评价中的应用

Application of randomized blind sample test in the external quality assessment schemes for clinical hematologic examination laboratories

目的：通过对承担国家免费孕前健康检查项目单位临检实验室进行临床血液学检验随机盲样考核，有效促进项目单位临床血液学检验水平和质量。方法制备高、中、低三个等级的5个不同浓度的盲样样本，采用统一编号（2013～2014年每年2次常规室间质评）和随机编号（2014年第1次常规室间质评同时进行1次随机盲样检测考核）相结合的方法进行质控品样本发放。项目单位临检实验室收到盲样样本后按要求进行检测。室间质评组织者对回报结果进行评分。结果134家参评单位在4次临床血液学常规室间质评中合格率分别为72．4％、97．8％、97．0％和98．5％，后3次均较第1次有较大增长，差异有统计学意义（ P＜0．05）。而随机盲样检测考核的合格率（84．3％）较同时进行的质评批次的合格率（97．0％）低，差异有统计学意义（ P＜0．05）。结论随机盲样检测考核可以帮助室间质评组织者及时发现实验室存在问题，有效促进参评实验室检验水平和质量。

Objective To improve the quality of the clinical hematologic examination laboratories in national free preconception health examination project by using randomized blind sample test in the external quality assessment （EQA ） schemes .Methods Blind samples for clinical hematologic examination were prepared as higher ,middle ,lower three levels .Samples were dispensed in u‐nified way which included 4 times conventional EQA and in random way which included 1 time blind sample test .Samples will be tested by Clinical hematologic examination laboratories in national free preconception health examination project .The feedback re‐sults were summarized and analyzed by EQA organizer .Results In 4 times of conventional EQA ,the rates of accepted score of 134 laboratories were 72 .4% ,97 .8% ,97 .0% and 98 .5% respectively .The rates of accepted score in last three times were statistically significant higher than that in the first time（P〈0 .05） .However ,the rates of accepted score （84 .3% ） in randomized blind sample test were significant lower than that（97 .0% ） in conventional EQA which was conducted at the same time（P〈0 .05） .Conclusion The use of randomized blind sample test may help the EQA organizer to find the problems in laboratories participated EQA and find effective way to improve the quality of the laboratories .