南充地区33家二级及以上医院临床检验危急值调查与分析

Investigation and analysis of critical values of clinical Laboratory in 33 second-level and above hospitals in Nanchong

目的了解南充地区检验危急值的管理情况,为进一步改进南充地区检验危急值设置及制订相应管理规范提供参考。方法现场调查南充地区33家二级及以上医院的检验危急值,采用Microsoft Excel 2016软件整理调查数据,采用SPSS20.0软件统计分析三级医院和二级医院危急值界限值的差异和不同性质医院危急值界限值的差异。结果南充地区二级及以上医院设置的检验危急值主要包括以下项目:白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(PLT)、血糖(Glu)、凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原、血钾、血钠、血钙、血氯、血尿素氮、肌酐(Cr)、心肌肌钙蛋白T、血淀粉酶、pH、氧分压、二氧化碳分压。三级医院Hb危急值下限界限值低于二级医院,差异有统计学意义(P=0.03),三级医院其余16项危急值项目界限值与二级医院比较,差异无统计学意义(P>0.05)。WBC、Hb、PLT、Glu危急值下限界限值,Cr危急值上限界限值在综合医院、中医院、妇幼保健院中比较,差异有统计学意义(P<0.05)。妇幼保健院WBC危急值下限界限值均高于综合医院和中医院(P=0.025、0.014),PLT危急值下限界限值均高于综合医院和中医院(P=0.005、0.029),Hb危急值下限界限值高于综合医院(P=0.017),Glu危急值下限界限值、Cr危急值上限界限值低于中医院(P=0.023、0.035)。结论南充地区二级及以上医院危急值项目选择及界限值相近。部分危急值界限值在不同性质的医院存在差异,医院需结合就诊的主体人群设置危急值界限。

Objective To understand the management of the inspection critical value in Nanchong area,and provide a reference for further improving the setting of the inspection critical value in Nanchong area and formulating corresponding management regulations.Methods The critical value of 33 second-level and above hospitals in Nanchong area was investigated on the spot,and the survey data was sorted by using Microsoft Excel 2016 software.SPSS20.0 software was used to statistically analyze the difference in critical value threshold between tertiary hospitals and second-tier hospitals and the difference in critical value thresholds of hospitals of different natures.Results The critical values set by the secondary and above hospitals in Nanchong area mainly include the following items:white blood cell count(WBC),hemoglobin(Hb),platelets(PLT),blood sugar(Glu),prothrombin time,activated partial thromboplastin time,fibrinogen,blood potassium,blood sodium,blood calcium,blood chlorine,blood urea nitrogen,creatinine(Cr),cardiac troponin T,blood amylase,pH,partial pressure of oxygen,partial pressure of carbon dioxide.The Hb lower limit value of the critical value items in tertiary hospitals was lower than that in second-level hospitals,and the difference was statistically significant(P=0.03).Compared with the other 16 critical value items in tertiary hospitals,the differences were not statistically significant(P>0.05).The lower critical value of WBC,Hb,PLT,Glu,and the upper critical value of Cr were compared in General Hospital,Chinese Medicine Hospital,and Maternal and Child Health Hospital,and the differences were statistically significant(P<0.05).The lower limit value of the WBC critical value in the Maternal and Child Health Hospital was higher than that of General Hospital and Chinese Medicine Hospital(P=0.025,0.014),and the lower critical value of PLT was higher than that of General Hospital and Chinese Medicine Hospital(P=0.005,0.029).The lower limit of Hb critical value was higher than the General Hospital(P=0.017),the lower limit of Glu critical value and the upper limit of Cr critical value were lower than those of Chinese Medicine Hospital(P=0.023,0.035).Conclusion The selection of critical value items and threshold values of secondary and above hospitals in Nanchong area are similar.Some critical value thresholds are different in different types of hospitals,and hospitals need to set critical value thresholds in accordance with the main population of the patient.