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[急诊入院时使用干化学法进行临床化学量的床边测定]

[Bedside determination of clinical-chemical quantities using dry chemistry in an emergency admission].

作者信息

Behr W, Barnert J, Wienbeck M

机构信息

Institut für Laboratoriumsmedizin, Zentralklinikum Augsburg.

出版信息

Med Klin (Munich). 1991 Dec 15;86(12):613-6, 660.

PMID:1770902
Abstract

We evaluated the clinical relevance and reliability of a solid phase chemistry apparatus (Seralyzer) installed for near-patient testing of CK, GOT, glucose and potassium in the emergency admission of our hospital. Calibrations and quality controls were done by technologists of the central laboratory, the analyses were performed by the nursing staff after appropriate training. The rapid availability of the laboratory tests shortened the diagnostic process in only 8% of the patients. Clinical chemistry test results, therefore, appear to be of minor importance in making the diagnosis in an emergency room. The coefficients of variation of the inter-operator imprecision varied between 2.1 and 8.8% (means = 5.06%), when the measurements were performed by persons with no professional laboratory training, and between 2.7 and 8.5% (means = 3.98%) for skilled laboratory personal. In order to test the accuracy we correlated the dry chemistry values measured by the nurses in the daily routine with the results of a wet chemistry system. The Spearman rank correlation coefficients ranged between 0.916 and 0.950. Thus after appropriate training non-laboratory personal is able to perform dry chemistry testing with adequate precision and accuracy provided a competent supervision is guaranteed.

摘要

我们评估了我院急诊科安装的用于床边检测肌酸激酶(CK)、谷草转氨酶(GOT)、葡萄糖和钾的固相化学分析仪(Seralyzer)的临床相关性和可靠性。校准和质量控制由中心实验室的技术人员完成,分析由经过适当培训的护理人员进行。实验室检测结果的快速获取仅在8%的患者中缩短了诊断过程。因此,临床化学检测结果在急诊室诊断中似乎不太重要。当由没有专业实验室培训的人员进行测量时,操作者间不精密度的变异系数在2.1%至8.8%之间(均值 = 5.06%),而对于熟练的实验室人员,变异系数在2.7%至8.5%之间(均值 = 3.98%)。为了测试准确性,我们将护士在日常工作中测得的干化学值与湿化学系统的结果进行了相关性分析。斯皮尔曼等级相关系数在0.916至0.950之间。因此,经过适当培训后,只要有称职的监督,非实验室人员能够以足够的精密度和准确性进行干化学检测。

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