肺癌手术后患者血液检验危急值分析及处理对策探讨

Analysis and countermeasures of critical values of blood test in lung cancer patients after operation

目的 分析肺癌手术后患者常见血液检验危急值的种类及特点,探讨危急值的处理对策。方法 收集67例肺癌手术后患者发生的136例次血液检验危急值资料,分析处理措施及效果。结果 危急值项目中报告最多的项目前4项依次为:生化全项分析49例次,占比36.03%;心梗心衰标志物44例次,占比32.35%;全血细胞分析22例次,占比16.18%;细菌培养加鉴定12例次,占比8.82%。报告最多的子项目前4项依次为:B型钠尿肽40例次,占比29.41%;血钠25例次,占比18.38%;白细胞计数10例次,占比7.35%;血钾10例次,占比7.35%。危急值发生时间最多的为手术当天及术后前3天,共发生89例次,占比65.44%。其中,手术当天13例次,术后第1天26例次,术后第2天25例次,术后第3天25例次。经积极处理,62例患者治愈出院,3例患者病情改善后转至当地医院继续治疗,2例患者死亡。结论 肺癌手术后患者病情变化较快,术后3天内为血液检验危急值高发期,严格执行危急值报告制度,并进行及时有效的处理,可有效防止严重并发症发生,提高治愈率,促进患者康复。

Objective To analyze the types and characteristics of common critical values of blood test in lung cancer patients after operation,and to explore the countermeasures of critical values.Method A total of 136 critical values of blood test in 67 lung cancer patients after operation were collected and the countermeasures and effect were analyzed.Result Among the critical value items,the top four items reported were 49 cases of total biochemical analysis(36.03%),44 cases of myocardial infarction and heart failure markers(32.35%),22 cases of whole blood cell analysis(16.18%) and12 cases of bacteria culture and identification(8.82%).The top four sub-items reported were 40 cases of B-type natriuretic peptide(29.41%),25 cases of serum sodium(18.38%),10 cases of white blood cell count(7.35%),and 10 cases of serum potassium(7.35%).The most critical value occurred on the day of operation and the first three days after operation in89 cases(65.44%).Among them,there were 13 cases on the day of operation,26 cases on the first day after operation,25cases on the second day after operation and 25 cases on the third day after operation.After treatment,62 cases were cured and discharged,3 cases were transferred to local hospital for further treatment and 2 cases died.Conclusion The condition of lung cancer patients changes rapidly after operation,and the peak period of critical values of blood test is three days after operation.Strict implementation of critical value reporting system and timely and effective treatment can effectively prevent serious complications,improve the cure rate and promote the recovery of patients.