动脉血气分析初始阶段分析前质量的评价

The evalation of arterial blood gas analysis quality control

目的 评价某二级医院动脉血气分析前水平,为基层医院评价动脉血气前水平提供借鉴.方法 收集宜宾市第三人民医院动脉血气分析标本6 101例.以氧分压作为判断标准.氧分压（PaO2）〈60 mm Hg为氧分压过低;PaO2≥200 mm Hg为氧分压过高;60 mm Hg≤PaO2〈200 mm Hg,认为氧分压可接受,该标本可接受.统计全院及标本较多科室标本氧分压过低、可接受、过高的比例,对结果进行比较.结果 全院标本氧分压过低535例（占比8.8%）,标本可接受5177例（84.9%）,氧分压过高389例（6.3%）.ICU氧分压过低9例（1.3%）,标本可接受623例（88.6%）,氧分压过高71例（10.1%）.骨一科标本氧分压过低4例（5.9%）,标本可接受50例（73.5%）,氧分压过高14例（20.6%）.呼吸血液科标本氧分压过低356例（11.4%）,标本可接受2772例（88.6%）,氧分压过高2例（0.0%）.神经内分泌科标本氧分压过低93例（20.0%）,标本可接受364例（78.1%）,氧分压过高9例（1.9%）.心血管消化内科标本氧分压过低32例（2.2%）,标本可接受1164例（80.9%）,氧分压过高243例（16.9%）.胸心神经外科标本氧分压过低5例（9.6%）,标本可接受39例（75.0%）,氧分压过高8例（15.4%）.科间标本质量,差异较大,差异有统计学意义（P〈0.05）,ICU和呼吸血液科标本质量相对较高.标本质量跟采集标本例数呈正相关（P〈0.05）.结论 二级医院动脉血气分析实验室前水平一般,采集标本例数较多的科室质量略高.需要加强训练,增加标本量,提高水平.

Objective To evaluate the quality of arterial blood gas analysis in a primary hospital.Methods A total of 6101 samples were enrolled,partial pressure of oxygen（PaO2） were regarded as judgement criteria.The cut-off value was 60 mm Hg and 200 mm Hg,PaO2〈60 mm Hg was defined as lower PaO2,PaO2≥200 mm Hg was defined as higher PaO2,60 mm Hg≤PaO2〈200 mm Hg was considered normal.The proportions of lower,higher and normal PaO2 from every department were compared.Results The number and ratio of lower,normal,higher PaO2 of total hospital were 535（8.8%）,5177（84.9%）,389（6.3%）,respectively.Those in orthopaedics department were 4（5.9%）,50（73.5%）,14（20.6%）.Those in pneumology department were 356（11.4%）,2772（88.6%）,2（0.0%）.Those in neurology department were 93（20.0%）,364（78.1%）,9（1.9%）.Those in cardiology department were 32（2.2%）,1164（80.9%）,243（16.9%）.Those in cardiothoracic surgery department were 5（9.6%）,39（75.0%）,8（15.4%）.Wide difference exists in each division′s samples,arterial blood gas analysis quality show positive correlation with the amount of samples.Conclusion In future,more samples should be carried out in this hospital to enhance the ability of arterial blood gas analysis.