医院POCT血糖仪应用现状分析

The using status quo and analysis of POCT glucose meter

目的调研医院POCT血糖仪在使用、规范及质量管理中的问题，分析解决办法，为提高院内POCT检测水平提供参考依据。方法2013年5至7月军事医学科学院附属医院开展3次调查问卷，了解院内POCT血糖仪的数量、品牌及使用情况；将各种血糖仪参加卫计委临检中心室间质评，所得检测结果与全自动生化分析仪进行比对分析。结果院内POCT血糖仪共5个品牌，有些临床科室血糖仪的数量和种类常发生变化。参与室间质评的4个品牌中，品牌Ⅲ有3个浓度检测结果精密度不达标，有2个水平的CV％分别为t1．9％和10．1％；余3个品牌均符合要求。3次比对结果的合格率分别为85．0％、92．0％、97．4％。结论医院应合理选择并正确使用POCT血糖仪，建立室内质控和室间质评管理体系，同时医院成立POCT质量管理委员会，定期开展仪器比对工作，保证临床POCT仪器的结果准确性和可靠性。

Objective To investigate the problems during using, standard and quality management of the POCT glucose meters in hospital, to analyze the solutions, and to provide reference data for improving the test level of POCT in hospital. Methods The amount, brand and application of portable glucose meters in the hospital were obtained by 3 rounds of surveillance from May to July in 2013. All of those glucose meters were taken part in external quality assessment of Clinical Laboratory Center of National Health and Family Planning Commission. The test results of those glucose meters were compared with that of automatic biochemical analyzer, the comparison results were then analyzed. Results The POCT glucose meters possessed 5 brands in our hospital, and the amount and type of glucose meters in some clinical departments were often changed. When 4 brands which were detected as quality control samples by ministry of health, the accuracy of detection results of 3 concentration of brand III were substandard, the CV% of two levels were 11.9% and 10. 1% respectively, the remaining 3 brands were in line with the requirements. The qualified percentages of 3 times of comparison were 85.0% , 92.0% and 97.4%. Conclusions The hospital should select the brand of portable glucose meters reasonably, correct use of glucose meters, and it is very necessary to build indoor and interstitial quality evaluation system, at the same time, suggesting the hospital to establish the POCT quality management team, to carry out the instrument comparison periodically, so to guarantee the accurate, reliable results of POCT in hospital.