血常规检验的常见误差原因探析

An Analysis of Common Mistakes in Blood Routine Examination

目的研究造成血常规检验结果误差的原因。方法从2016年9—12月期间到该院治疗的患者中随机选取200例,抽取患者3 m L静脉血进行血常规检验,使用不同的方式采集血液标本,包括微量加样器、血红蛋白吸管以及稀释器等,将患者的血常规指标和临床资料进行对比。结果将血液标本放置一段时间后再送检,检验结果与立即送检的结果差异较大,立即送检的血液标本中的血小板计数为167.2×109/L,4 h后为303.8×109/L,血小板指数大幅度上涨,立即送检的血液标本中的白细胞计数为6.3×1012/L,4 h后为4.8×1012/L,白细胞指数明显下降;常温保存和冷藏保存的时候,血常规指数无明显变化;使用血红蛋白吸管取样的标本的检验结果比使用稀释器和微量加样器的平均值低,其中较为明显的就是红细胞指数,使用血红蛋白吸管采样的血液标本中的红细胞平均值为3.94×1012/L,使用稀释器采样的标本中的红细胞平均值均达到了4.34×1012/L。结论造成血红蛋白吸管血常规检验结果出现误差的因素有很多,其中包括:取样方法的不同,检测时间的不同以及工作人员的专业度等。在临床检测中应作出相对应的解决措施,提升血常规检验结果的准确度,确保血常规检验结果可以正常的应用到临床诊断中。

Objective This paper tries to study the cause of the error of routine blood test. Methods 200 patients from September to December 2016 in this hospital were randomly selected, 3 m L venous blood for each patient was collected for blood test in different ways, including a micropipette, hemoglobin straw and dilution device, and then the blood routine index and clinical data of patients were compared. Results The blood samples were placed for a period of time and then for the inspection, and the inspection results were different from that for immediate inspection, the platelet count of 167.2×109/L,4 hours after was 303.8×10^9/L, the platelet index rose sharply, white blood cell count in blood samples for inspection immediately was 6.3 ×10^12/L, after 4 hours was 4.8 ×10^12/L, white blood cell index decreased significantly; when stored at room temperature and refrigerated storage, blood routine index had no significant change; the use of hemoglobin straw sampling specimens test results were lower than using dilutors pipette and microsampler, the more obvious was the red blood cell index, the average value of blood samples by hemoglobin straw sampling was 3.94×10^12/L, the average value of the use of diluter red blood cells reached 4.34×10^12/L. Conclusion There are many factors that cause errors in the blood test results of hemoglobin pipette, including sampling methods, detection time, and the degree of specialization of the staff. In the clinical examination, corresponding measures should be taken to improve the accuracy of routine blood test results, so as to ensure the results of routine blood test to be applied to clinical diagnosis.