Meites S
Clinical Chemistry Laboratory, Children's Hospital, Columbus, OH 43205.
Clin Chem. 1988 Sep;34(9):1890-4.
This is updated information on acceptable practice in skin puncture and blood collection in infants, as well as on the devices used, with the additional aim of emphasizing major problem areas and some tentative solutions. Consensus standards for skin puncture have little experimental support, and evade the hard fact that studies are needed to clarify optimum sites for puncture and depth and width of lancets, and to assess the effects of compression and skin resistance in the puncturing process. Preliminary data revealed that the puncturing depth of 2.4 mm recommended for the newborn is excessive. In four of 14 newborns at necropsy, the distance from posterior planar skin surface to underlying bone ranged between 2.0 and 2.2 mm. An experimental lancet, with a 1.8-mm tip length and a diameter of 0.79 mm yielded customary blood volumes from newborns in three of the four pediatric centers where it was tested. Lack of success with the lancet was attributed to inexperienced phlebotomists, not to the lancet's decreased size. Also reviewed are problems with common devices used, and the need for examining the "economy" of blood collection.
这是关于婴儿皮肤穿刺和血液采集的可接受操作以及所用设备的最新信息，其额外目的是强调主要问题领域和一些初步解决方案。皮肤穿刺的共识标准几乎没有实验依据，回避了一个严峻事实，即需要开展研究来明确最佳穿刺部位、采血针的深度和宽度，并评估穿刺过程中压迫和皮肤阻力的影响。初步数据显示，为新生儿推荐的2.4毫米穿刺深度过大。在尸检的14例新生儿中，有4例从皮肤后平面表面到下方骨骼的距离在2.0至2.2毫米之间。一种试验性采血针，尖端长度为1.8毫米，直径为0.79毫米，在测试它的四个儿科中心中的三个，从新生儿身上采集到了常规血量。采血针使用失败被归因于采血人员缺乏经验，而非采血针尺寸减小。文中还回顾了常用设备存在的问题，以及检查血液采集“经济性”的必要性。
