北京地区成人危急值界限值分布情况的调查研究

Investigation on the distribution of critical value limits in adult patients in Beijing

目的调查北京地区成人危急值界限值的分布情况，为制定区域性《检验危急值规范化管理技术指南》提供依据，从而推进检验危急值精准管理。方法收集北京地区2015年1月1日至5月31日期间三级及以上医疗机构检验科临检血液、临床生化、凝血、血气项目的出现危急值的病例记录共110398条，将各危急值项目按患者就诊科室、主要诊断作为筛选条件，采用Kruskal—Walis检验，两两比较各组差异性。再将合并后通用组按性别作为筛选条件，采用Mann—Whithey U检验，比较各组的差异性，最终确定危急值分层界限值。结果除ca上限、Glu下限、pCO2上限、pH上下限、Hb上限外，其余各危急值项目均因患者就诊科室／主诊断不同及或性别不同而使危急值界限值差异有统计学意义。结论根据不同就诊科室／疾病类型、性别制定了对各危急值项目的分层界限值。

Objective To investigate the distribution of critical values of adults in Beijing, to provide the evidence for the formulation of the Standardized Management Guideline in Critical Values, in order to promote the accurate management of critical values. Methods A total of 110 398 data of critical values from the tertiary and above medical institutions during January 1 to May 31 in 2015 in Beijing were collected by the way of on-site inspection, covering the disciplines of hematology, clinical chemistry, coagulation and blood gas analysis. Fristly, the selected critical values were classified by the factor of admission departments and disease types, then were analyzed by using Kruskal-Wallis test, to compare the differences in each group. Secondly, the combined groups were classified by the factor of gender then were analyzed by using Mann-Whithey U test, to compare the differences in each group. Finally, the stratification thresholds of critical values were established. Results Except for the upper limits of Ca, pH, pCO2, Hb and the lower limits of Glu, pH, the rest of thresholds of critical values had significant differences due to different admission departments and disease types and/or gender. Conclusion Depending on the different admission departmentsces disease types and/or gender, hierarchical limit values on each critical value were formulated.