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处理已知分析前问题的新方法:在临床生化检验中使用透照灯代替止血带以方便静脉穿刺和消除血液淤滞。

New ways to deal with known preanalytical issues: use of transilluminator instead of tourniquet for easing vein access and eliminating stasis on clinical biochemistry.

机构信息

Post Graduate Program of Pharmaceutical Sciences, Department of Medical Pathology, Federal University of Parana, Curitiba, Parana, Brazil.

出版信息

Biochem Med (Zagreb). 2011;21(2):152-9. doi: 10.11613/bm.2011.024.

Abstract

INTRODUCTION

Tourniquet due venous stasis can alter both concentration and/or activity of several blood analytes, but is rarely regarded as an issue of laboratory variability. To overcome the problem transillumination devices (TD) have been proposed for a stasis-free phlebotomy. In this paper the use of a TD in place of tourniquet during blood collection has been evaluated.

MATERIALS AND METHODS

Blood was collected from 250 volunteers divided in five homogenous groups of tourniquet times (G1: 30 sec, G2: 60 sec, G3: 90 sec, G4:120 sec, G5: 180 sec) and compared to blood obtained using TD. All samples were analyzed for glucose (GLU), total protein (TP), albumin (ALB), triglycerides (TRIG), potassium (K), sodium (NA), phosphate (PHOS), calcium (CA), alkaline phosphatase (ALKP) and magnesium (MG).

RESULTS

In respect of TD, G1 did not show statistically significant increases in all clinical chemistry tests; G2 showed increases for GLU, TP, ALB, TRIG, K, CA, MG and ALKP. G3 and G4, showed no significant increase only for PHOS. G5 showed significant increases in all the tests evaluated. Moreover, clinically significant variations were observed for TP, ALB, K and CA in G2 to G5; for NA in G3 to G5; for MG in G4 and G5; for GLU, TRIG, ALKP only in G5.

CONCLUSIONS

These results support the application of TD in blood collection for routine clinical chemistry laboratory tests, suggesting its use should be more diffused.

摘要

简介

止血带引起的静脉淤滞会改变几种血液分析物的浓度和/或活性,但很少被认为是实验室变异性的问题。为了解决这个问题,已经提出了透照设备(TD)用于无淤滞的采血。本文评估了在采血过程中使用 TD 代替止血带。

材料和方法

从 250 名志愿者中采集血液,分为止血带时间(G1:30 秒、G2:60 秒、G3:90 秒、G4:120 秒、G5:180 秒)的五个均匀组,并与使用 TD 获得的血液进行比较。所有样本均用于分析葡萄糖(GLU)、总蛋白(TP)、白蛋白(ALB)、甘油三酯(TRIG)、钾(K)、钠(NA)、磷(PHOS)、钙(CA)、碱性磷酸酶(ALKP)和镁(MG)。

结果

在 TD 方面,G1 在所有临床化学测试中均未显示出统计学上的显著增加;G2 显示 GLU、TP、ALB、TRIG、K、CA、MG 和 ALKP 增加。G3 和 G4 仅 PHOS 无显著增加。G5 显示所有评估的测试均有显著增加。此外,在 G2 至 G5 中观察到 TP、ALB、K 和 CA 的临床显著变化;在 G3 至 G5 中观察到 NA;在 G4 和 G5 中观察到 MG;仅在 G5 中观察到 GLU、TRIG、ALKP。

结论

这些结果支持在常规临床化学实验室测试中应用 TD 进行血液采集,表明应更广泛地使用。

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