全自动流水线生化常规检验中危急值复查的临床研究

Clinical investigation on the critical value repeat testing in the routine biochemical detedction of total laboratory automation

目的探讨全自动流水线生化常规检验中危急值复查结果的意义。方法回顾性分析全自动流水线生化常规检验的100965份生化标本中出现危急值的标本在流水线上复检情况。结果在100965份生化标本中有1808份生化危急值（占1．79％），复检K^＋标本符合率为89．3％，Na^＋标本符合率为90．2％，Cl^-标本符合率为88．7％，Ca^2＋标本符合率为96．7％，尿糖标本符合率为98．6％，HCO3^-标本符合率为92．3％，血淀粉酶测定标本符合率为96．4％，尿淀粉酶测定标本符合率为96．7％，P^3＋标本符合率为95．2％，总符合率为92．1％。复检所需平均时间为35min。结论全自动流水线生化常规标本危急值复检结果和原检结果符合率较高，流水线自动复检耗时较长；对于危急值，流水线自动复检不及人工手动复检时效性高，复检后回报危急值结果并不全是必要的。

Objective To investigate the significance of critical value repeat testing in the routine biochemical samples of total laboratory automation. Methods A total of 100 965 routine biochemical samples were carried in our total laboratory automation, in which critical value repeat testings were retrospectively analyzed. Results There were 1 808 biochemical critical values in 100 965 biochemical specimens（ 1.79% ）. By repeat testing, the coincidence of K^＋ was 89. 3%, 90. 2% of Na^＋ , 88.7% of Cl^-, 96.7% of Ca^2＋ , 98.6% of GLU, 92.3% of HCO3^- , 96.4% of amylase determination blood, 96.7% of urinary amylase, 95.2% of P^3＋ , the total coincidence rate was 92. 1%. The average time required for reinspection was 35 minutes. Conclusions The reexamination results of critical value of routine biochemical specimens in automatic assembly line and original test result have high coincidence rate, but the time consuming of repeat testing is long; to critical value, the chronergy is better by artificial repeat testing than reran by the total laboratory automation. The critical value report after return is not always necessary.