凝血检验的影响因素观察

The influence factors observation of coagulation test

目的：探讨凝血检验的相关影响因素。方法2013年1月～2015年2月随机选取200份血液样本进行凝血检验，对比分析不同放置时间、离心时间、溶血状态下的凝血酶原时间、活化部分凝血活酶时间、凝血酶时间、纤维蛋白原等四项检验结果的差异性。对200例患者样本进行复查，统计凝血检验正确率、失误率，观察上述指标与检验失误之间的关系。结果样本放置2、4h的凝血活酶时间、凝血酶时间和纤维蛋白原存在统计学差异（P＜0.05）；离心5min的凝血酶原时间、凝血活酶时间明显低于离心10min的结果，差异有统计学意义（P＜0.05）；溶血前后的四项指标均存在统计学差异（P＜0.05）；凝血检验的正确率为90.0%，失误原因包括仪器因素、样品处理情况、内源性因素及其他。结论凝血检验指标的质量控制需缩短标本的放置时间，严格控制离心时间，防止发生溶血，以免造成假性检验结论误导医师作出错误判断。

Objective To explore and discuss the related influence factors of coagulation test.Methods 200 blood samples from January 2013 to February 2015 were randomly selected for coagulation tests. The four test results difference of different storage time, centrifugation time, prothrombin time of hemolytic state, activated partial thromboplastin time, thrombin time and fibrinogen etc were compared and analyzed. 200 patients’ samples were reviewed to obtain the statistics of coagulation tests accuracy rate and error rate and to observe the relationship between these indicators and inspection mistakes.ResultsThe thromboplastin time of samples placed 2 h and 4 h, thrombin time and fibrinogen had statistical differences（P〈0.05）. The prothrombin time and thromboplastin time of centrifugation 5min were dramatically lower than those of centrifugation 10min, which had statistical significance between the differences（P〈0.05）. There had statistical differences between the four indicators of the before and after hemolysis（P〈0.05）. The accuracy rate of coagulation tests was 90.0%, while the error causes included instrument, sample processing, endogenous factors and others. ConclusionThe quality control of coagulation tests index had to shorten specimen placement time, strictly control centrifugal time, and prevent the hemolysis occurrence, in case to avoid false test results to mislead the false judgments made by doctors.