危急值的分科管理在临床中的应用

Hierarchical Management of Critical Values in Clinical Application

目的统计实验室危急值在各临床科室的数值分布,为危急值的临床应用研究及危急值项目界限值优化设置提供参考,进而提高临床运行效率,持续满足患者生命所需。方法收集实验室2015年4月1日至2015年9月30日期间临检血液、凝血、生化所有危急值数据,通过统计学处理软件SPSS 20.0对数据进行统计分析。结果血小板、纤维蛋白原危急值低值与实验室设置的界限值有一定差距。儿科胆红素危急值高值明显低于成人,ICU、肿瘤科、普外科出现的淀粉酶危急值及ICU、心内科出现的APTT危急值均值远高于实验室设置的界限值范围。结论根据统计分析结果,部分危急值项目的界限值设置范围比临床实际病情宽,应进行适当调整。同时,应考虑根据患者年龄、科室等分科设置不同的危急值项目的界限值,进一步合理、有效的利用危急值,提升医疗工作效率,降低医疗风险。

Objective To provide reference for the clinical application of critical values in clinical departments, so to improve the clinical efficiency and to meet the needs of patients. Methods The collecting of blood, blood coagulation,and biochemical of all critical data from September 30,2015 to-April 1,2015 in the laboratory was conducted, and the analysis of the data by statistical software SPSS 20 was followed. Results There was a gap between the low value Of platelet and fibrinogen and the threshgld of laboratory setting. The critical value of bilirubin was significantly lower in children than that of adults, and the values of ICU in the ICU, oncology department, department of general surgery, and the value of. APTT. in department of Cardiology Were much higher than that in the laboratory. Conclusion According to the ~esults of statistical analysis, the threshold setting, range of some critical value items is broader than that of clinical practice, and the appropriate adjustment should be carried out. At the same time, the patient＇s age, specialty department, etc. should be considered, to set the limits of different critical values. Hierarchical management and further reasonable and effective use of critical values, can improve the efficiency of medical work, reduce medical risks.