372例静脉血标本发生溶血的原因追踪分析及对策

An analysis and countermeasures of hemolysis in 372 venous blood specimens

目的:追踪和探索静脉血标本采集、运送、检验全过程对溶血的影响因素,并制定对策。方法:由质控小组按追踪地图对我院在2015年1-6月发生溶血的372例标本进行系统追踪访谈并分析。结果:导致标本溶血的主要原因是扎止血带过紧或时间过长86例(23.1%)、反复穿刺及采血时空气进入标本产生气泡67例(18.0%)、用力拍打血管57例(15.3%);通过实施对策后,2016年同期溶血率为15.2%,显著低于2015年的20.2%(P<0.01)。结论:多部门联动的系统追踪法更能发现导致静脉标本溶血的深层次问题,为减少标本溶血提供针对性的预防措施。

Objective: To explore the influencing factors of hemolysis in the collection, delivery and testing of venous blood specimens, and to formulate countermeasures. Methods: The QC team tracked 372 samples of hemolysis in the hospital from January to June 2015 according to a follow-up map. Results: The hemolysis of the specimens was caused by too tight or prolonged bleeding(23.1%), repeated punctures and air entering the specimens resulting in air bubbles during the blood collection process(18%), and venous vascularization(15.3%). The hemolysis rate in the same period of 2016 was significantly lower than 2015(P<0.01). Conclusion: The multisector linkage system tracking method can find the deep problem of hemolysis of venous specimens and provide targeted measures to reduce hemolysis of specimens.