新生儿疾病筛查血斑采集方法的改良与应用

Improvement and application of blood spot collection method in neonatal disease screening

目的探究改良后的血斑采集血液方法在新生儿疾病筛查过程中的应用及效果。方法第一阶段：回顾性选取2013年4月~2014年6月在我院接受筛查的新生儿2826例,根据出生日期单双号将其分为实验组A（单号,n=1398）和对照组A（双号,n=1428）。对照组A采用常规方法进行采血,实验组A采用利多卡因涂擦加足跟定位斜刺法（改良法）进行采血。第二阶段：回顾性选取2014年7月~2015年3月在我院接受筛查的新生儿2526例,根据出生日期单双号将其分为实验组B（单号,n=1398）和对照组B（双号,n=1128）。对照组B采用利多卡因涂擦加足跟定位斜刺法进行采血,实验组B采用大隐静脉抽0.1 ml血液后滴在血片上制成血斑的方法进行采血。比较4组新生儿一次采血的成功率及滤纸干血斑质量情况。结果第一阶段：实验组A的一级血片率、血片合格率、一次采血成功率分别为88.70%、99.50%、95.00%,高于对照组A的41.20%、86.80%、63.00%,差异有统计学意义（P〈0.05）。第二阶段：实验组B新生儿的一级血片率、血片合格率分别为100.00%、100.00%,高于对照组B的89.10%、99.60%,差异有统计学意义（P〈0.05）;对照组B的一次采血成功率为94.00%,高于实验组B的69.00%,差异有统计学意义（P〈0.05）。实验组A与对照组B的疼痛程度明显轻于对照组A和实验组B,差异有统计学意义（P〈0.05）。结论改良后的采集血液方法在筛查新生儿疾病的过程中效果显著,一次性血液采集成功率较高且疼痛度轻,值得广泛推广。

Objective To explore the application and effects of beyond bloodstain blood collected method in newborns disease screening. Methods The first phase：2826 newborn babies who screened in our hospital from April 2013 to June2014 were selected retrospectively.They were divided into the experimental group A（odd numbers,n=1398） and control group A（even numbers,n=1428） according to the date of birth.In the control group A,the routine method was used to carry out blood collection.In the experimental group A,lidocaine plus heel inunction orientation oblique insertion（improved method） was used for blood.The second phase：2526 newborn babies who screened in our hospital from July 2014 to March 2015 were selected retrospectively.They were divided into the experimental group B（odd numbers,n=1398） and control group B（even numbers,n=1128） according to the date of birth.In the control group B,lidocaine plus heel inunction orientation oblique insertion（improved method） was used for blood.The experimental group B was treated with great saphenous vein pumping 0.1 ml blood drops in blood after the blood spot piece made of blood.The success rate of blood sampling and the quality of dried blood spot of filter paper were compared among the 4 groups. Results The first phrase：the rate of first grade blood,blood film pass rate,the success rate of blood sampling in the experimental group A were 88.70%,99.50%,95.00%,higher than the 41.20%, 86.80%,63.00% in control group A,the difference was statistically significant（P〈0.05）.The second phrase：the rate of blood slice and the passing rate of blood in the experimental group B was100.00% and 100.00% respectively,higher than 89.10%,99.60% in the control group B,and the difference was statistically significant（P〈0.05）.The success rate of blood collection in the control group B was 94.00%,higher than 69.00% in the experimental group B,and the difference was statistically significant（P〈0.05）.The pain of experimental group A and control group B was significantly lighter than that of the control group A and experimental group B respectively,the difference was statistically significant（P〈0.05）. Conclusion Beyond blood collected method in newborns disease screeninghas obvious effects,success rate of once blood collection is high and with less pain.It is worth to popularize.