我国2017年常规生化检验血液标本可接受性的现状调查

National survey of blood specimen acceptability for clinical chemistry tests in 2017

目的调查2017年我国临床实验室常规生物化学(生化)检验血液标本可接受性的现状。方法向参加国家卫生健康委员会临床检验中心常规生化室间质量评价的临床实验室发放调查表,调查内容包括一般情况调查和标本不合格情况调查,要求各实验室记录从2017年7月1日至31日所有不合格标本的相关信息。实验室通过网络平台在线回报数据。结果共回收866份有效问卷,参与实验室接收的标本总数是15 981 752,不合格标本总数为12 200,总体拒收率为0.076%。不合格标本主要的拒收原因是溶血(33.98%)、标本量不足(10.78%)和乳糜血或脂血(10.62%)。标本拒收率与标本来源部门、容器类型、标本类型、运输方式和采血人员相关。结论我国不合格标本的接收与管理制度有待完善,实验室应提高对检验前阶段的重视,常规监控和多水平地分析不合格标本,识别原因并采取相应措施。

Objective To investigate the status of blood specimen acceptability for clinical chemistry tests in routine medical laboratories of China. Methods The questionnaires were assigned to the laboratories which participated in the routine chemistry external quality assessment（ EQA） programs proposed by National Health Commission for Clinical Laboratory. The questionnaires included general information of participants and information about unacceptable blood specimens. Participants were required to record all the information concerning unacceptable blood specimen received from 1 stto 31 stJuly,2017. The data from each laboratory were reported and collected via special online system. Results A total of 866 valid questionnaires were collected. Of 15 981 752 specimens received during the data collection period unqualified 122 00 specimens were rejected with overall rejection rate of 0.076%. The main reasons for unacceptable specimens were hemolysis（ 33.98%）,insufficient specimen quantity（ 10.78%） and chylemia/lipemia（ 10.62%）. The rejected specimens were related to the original laboratories,types of container and specimen,transportation manner and operating staff of blood collection. Conclusion Certain problems existed in the receiving and management system for unqualified blood specimen in our country and remaining to be perfected. The clinical laboratories should pay more attention for pre-examination stage,including routinely monitoring unacceptable specimens,analyzing related data at the most possible granular levels,identifying the main problem and taking effective measures.