全自动生化分析仪检测溶血指数的临床应用

The Clinical Application of Hemolysis Index Detected by Automatic Biochemical Analyzer

目的探究检验标本溶血的原因和针对性干预措施,优化分析前环节,提高检验质量。方法选取2019年1月至2020年12月临床送检的98617例静脉血标本,采用VITROS 5600生化免疫分析仪自动检测溶血指数(HI),观察溶血标本的分布情况及构成比。利用实验室信息系统(LIS)调查溶血标本的相关信息,分析、总结影响标本溶血的因素并采取质控措施后,再次选取2021年1月至4月的24837例标本,处理方法同上,对比质控前后溶血率的变化。数据的分析处理使用Excel 2019和SPSS 26.0统计软件。结果标本总溶血率为6.98%,分析前环节(尤其是标本采集操作)可解释绝大部分标本溶血。患者的自身因素,如性别、年龄、疾病科室对标本溶血率存在一定的影响。采取质控措施后,2021年1月至4月标本溶血率降低为5.40%,显著低于质控前(P<0.001)。结论分析前过程和患者的自身因素均对标本溶血产生不同程度地影响,其中,分析前过程最为关键。对此,检验科应采取针对性措施加强质量控制,为临床诊疗提供客观依据。

Objective To investigate the cause of hemolysis in test specimens and related targeted interventions,so as to optimize the pre-analytical phase and improve test quality.Methods 98617 venous blood specimens sent for clinical examination from January,2019 to December,2020 were selected for the study,and the hemolysis index(HI)was automatically detected by VITROS 5600 biochemical analyzer to observe the distribution and composition ratio of hemolyzed specimens.The Laboratory Information System(LIS)was used to investigate the information related to hemolyzed specimens.We then analyzed and summarized the factors affecting the hemolysis of specimens and took quality control measures based on results.After that,24837 specimens from January to April of 2021 were selected and processed as above to evaluate the changes in hemolysis rate before and after quality control.The data were analyzed and processed using Excel 2019 and SPSS 26.0 statistical software.Results The total specimen hemolysis rate was 6.98%,and the procedures of pre-analytical phase(especially specimen collection operations)explained the vast majority of specimen hemolysis.There was an influence from patient’s personal characteristics such as gender,age,and disease department on the rate of hemolysis of specimens.With quality control measures,the rate of specimen hemolysis was reduced to 5.40%from January to April of 2021,which was significantly lower than before quality control(P<0.001).Conclusion Both the pre-analytical phase and the patient’s personal characteristics have different degrees of influence on specimen hemolysis,with the pre-analytical phase being the most critical factor.In this regard,the laboratory department should take targeted measures to strengthen quality control and provide an objective reference for clinical diagnosis and treatment.