骨髓读片会对提高骨髓细胞形态学检验质量的价值

The value of bone marrow smear-reading seminar to improve the inspecting qualityin of bone marrow cell morphology

目的探讨骨髓读片会对提高骨髓细胞形态学检验质量的价值。方法采用问卷调查的方式,了解我省医院骨髓检验现状与需求,有针对性地选择少见、罕见、疑难病种及骨髓细胞形态学室间质量评价(EQA)中高误诊率骨髓片,运用多媒体系统和显微镜直接读片的方式进行读片讨论、分析。结果1.2002年至今举办四次读片会,其中专题报告18篇、导向性读片17份、高误诊率EQA标本读片21份、疑难标本读片约25份,使参会者拓展视野、更新知识,非常有益于骨髓涂片细胞形态学整体判断水平的提升。2.骨髓EQA成效显著,诊断完全符合率逐年稳步提高,2002年仅55.2%,读片会后,2003年、2004年、2005年依次上升至76.2%、70.9%、85.8%,差异具统计学意义P【0.005,M1等病种的完全符合率均有显著提高。3.末次读片会问卷调查显示,有96.7%的医院认为,骨髓读片会对提高实验室诊断水平有帮助。结论骨髓读片会配合骨髓EQA,能有效提高骨髓检验质量。

Objective To explore to the value of bone marrow smear-reading seminar to improve the inspecting quality of bone marrow cell morphology.Methods A questionnaire was conducted to understand current situation and requirements of bone marrow smear inspecting in our province. Bone marrow smears from rare blood diseases or misdiagnosed ones in EQA would be selected for discussion and analysis via multi media system and microscope. Results 1.Four times smear-reading seminars were put up from the year 2002 to now,of them,there were 18 special topic reports,and 17 directed smear-reading samples,21 with high misdiagnosis rate and 25 with difficulty in EQA. It made participants to broaden their visual field and renew their knowledge,and was very beneficial to enhancing whole level in morphology. 2.The progress of EQA in bone marrow cell morphology was significant. The coincident rates were remarkably improved year after year via smear-reading seminar (55.2% in 2002 being increased to 76.2%,70.9% and 85.8% respectively in 2003,2004 and 2005,P<0.005) and so was the coincident rates of M1 and other diseases. 3.The questionnaire for smear-reading seminar showed that 96.7%hospitals believed that the bone marrow smear-reading seminar can help improve the diagnosis level in lab. Conclusion The smear-reading seminar together with EQA can improve the inspecting quality of bone marrow smear effectively.