2018—2022年京津冀血液筛查实验室检测前质量不合格标本情况分析

Analysis of unqualified samples before blood screening laboratory testing in the Beijing Tianjin Hebei Region from 2018 to 2022

目的 探讨2018—2022年京津冀15家血液筛查实验室(血站实验室)检测前质量不合格标本的情况及存在问题,为提升京津冀血站实验室质量同质化建设提供数据支持。方法 选取北京、天津和河北3个地区的血液中心和中心血站的15家血站实验室,其中包括3家血液中心实验室和12家地市级中心血站实验室,分别用代码A~O表示。收集15家血站实验室2018—2022年检测前接收标本总数、质量不合格标本总数以及常见不合格原因(溶血、乳糜、容量不足量、血细胞比容异常、采集后未按要求及时离心和其他原因等)对应标本数,分析检测前标本的不合格情况。结果2018—2022年15家血站实验室检测前质量不合格标本率为1.98?,呈下降趋势,由2.54?下降至1.57?。标本质量不合格原因5年来保持稳定,占比依次是乳糜(74.72%)、溶血(7.41%)、容量不足量(5.42%)、其他原因(4.42%)、血细胞比容异常(4.35%)、采集后未按要求及时离心(3.68%)。15家血站实验室之间检测前质量不合格标本率的比较,差异有统计学意义(P<0.05)。与检测前总体质量不合格标本率相比,11家实验室低于总体水平,其中4家持续保持稳定状态。结论 15家血站实验室的检测前过程控制总体良好,但由于各血站在检测前标本管理过程的流程设计和工作模式的不同导致统计数据存在差异,部分实验室仍有改进空间。

Objective To explore the situation and existing problems of unqualified samples before testing in 15 blood screening laboratories(blood station laboratories)in Beijing,Tianjin and Hebei from 2018 to 2022,and provide data support for improving the quality homogenization construction of blood station laboratories in Beijing,Tianjin and Hebei.Methods A total of 15 blood station laboratories in blood centers and central blood stations in Beijing,Tianjin and Hebei were selected,including three blood station laboratories and 12 prefecture-level central blood station laboratories,which were denoted by codes A-O respectively.The total number of samples received before testing,the total number of unqualified samples and the number of samples corresponding to common unqualified reasons(hemolysis,chyle,insufficient volume,abnormal hematocrit,failure to centrifuge in time after collection and other reasons)in 15 blood bank laboratories from 2018 to 2022 were collected,and the unqualified samples before testing were analyzed.Results The overall rate of unqualified samples before testing in 15 blood station laboratories from 2018 to 2022 years was 1.98‱,showing a downward trend,from 2.54‱to 1.57‱.The reasons for unqualified had remained stable in the past five years,with the following proportions:chyle(74.72%),hemolysis(7.41%),insufficient volume(5.42%),other reasons(4.42%),abnormal hematocrit(4.35%),and failure to centrifuge in time as required after collection(3.68%).There was a statistical difference in the rate of unqualified samples before testing among 15 blood bank laboratories(P<0.05).Compared to the overall rate of unqualified samples,11 laboratories were below the overall level,with four laboratories maintaining a stable state.Conclusions The pre-testing process control of 15 blood station laboratories is generally good.However,due to the different process designs and working modes of sample management before testing in various blood stations,there are statistical differences in statistical data,and some laboratories still have room for improvement.