血液分析仪血细胞显微镜复检的必要性分析

Analysis of necessity by blood analyzer hemocyte microscope reinspection

目的探讨血液分析仪自动检测后血细胞涂片显微镜复检的必要性。方法回顾性分析血细胞分析仪检测后手工血涂片显微镜复检的1401份标本,计算镜检符合率和不符合率。结果标本复检原因包括:无白细胞(WBC)分类结果、WBC计数异常、WBC分类异常、红细胞(RBC)或血红蛋白(HGB)异常、血小板(PLT)异常及其他。1401例复检样本中,镜检符合率为68.1%(954/1401),不符合率为31.9%(447/1401)。1401例复检标本镜检出323例异常细胞,其中原始细胞38例、幼稚细胞72例、中晚幼粒细胞13例、中性粒细胞毒性变124例、异型淋巴细胞11例、晚幼红细胞10例、红细胞形态异常26例、大血小板8例、血小板聚集15例及其他异常6例。结论血液分析仪检测后进行手工显微镜复检对于保证血细胞检验报告的准确性是十分必要的,并且能使临床减少误诊和漏诊。

Objective To investigate necessity by hemocyte smear microscope reinspection after blood analyzer automatic detection. Methods A retrospective analysis was made on 1401 samples in manual hemocyte smear microscope reinspection after blood analyzer automatic detection. Their microscopic coincidence rate and non-coincidence rate were calculated. Results Causes of reinspection included no white blood cell（WBC） classification outcome, abnormal WBC count, abnormal WBC classification, abnormal red blood cell（RBC） or hemoglobin（HGB）, abnormal platelet（PLT） and other reasons. Among the 1401 samples in reinspection, their microscopic coincidence rate was 68.1%（954/1401） and non-coincidence rate was 31.9%（447/1401）. Reinspection in 1401 samples showed 323 cases with abnormal cells, including 38 cases with archaeocyte, 72 cases with juvenile cell, 13 cases with middle-late granulocyte, 124 cases with neutrophil toxicity, 11 cases with abnormal lymphocyte, 10 cases with orthochromatic normoblast, 26 cases with abnormal red cell morphology, 8 cases with large platelet, 15 cases with platelet aggregation and 6 cases with other abnormalities. Conclusion Manual microscope reinspection after blood analyzer automatic detection is necessary in guaranteeing accuracy of hemocyte detection, along with decreased clinical misdiagnosis and missed diagnosis.