影响临床化学检验分析前质量的因素及对策

Factors affecting the pre-analysis quality in clinical chemistry tests and corresponding countermeasures

目的 :探讨影响临床化学检验分析前质量的因素 ,重新认识分析前质量控制与管理的重要性 ,建立分析前质量控制综合管理体系。方法 :用VFP6 .0建立数据库管理系统 ,对 1999年 6月至 2 0 0 2年 5月临床化学检验中的常见问题进行统计分析 ,把样本合格率作为临床部门的质控指标。结果 :临床化学检验的差错发生率为 1.5 3‰～ 2 .0 4‰。分析前、分析中和分析后环节差错构成比分别为 6 4 .2 5 %、2 3.83%和 11.92 %。采样不规范、样本送检延时、样本不合格和病人未按规定准备是影响分析前质量的前 4位因素。结论 :临床化学检验分析前质量控制是强化全面质量保证的必要阶段和确保结果准确及时的前提 ,需要检验人员。

Objective:To investigate the factors affecting the pre-analysis quality in clinical chemistry tests,and to recognize the importance of quality control and management before analysis, also to establish the synthetic management system of pre-analysis quality control.Methods:The database of management system was established by VFP6.0,and the common problems were statistically analysed in clinical chemistry tests from June of 1999 to May of 2002, and the qualified rate of samples was made the quality control index of clinical department.Results:The error occurrence rate of clinical chemistry tests was 1.53‰-2.04‰.The error constitution ratio of pre-analysis, mid-analysis and post-analysis were 64.25%,23.83% and 11.92%,respectively.The first four factors affecting the pre-analysis quality were unstandard sampling,delayed sample delivering,unqualified sample,and unstandard preparation of patients.Conclusion:The pre-analysis quality control of clinical chemistry tests is the essential stage in emphasizing quality control and the prerequisite of ensuring the precise and timely results.It needs the effort and participation of laboratory staffs,clinical medical workers and patients.