不同采血方法对急诊科静脉留置导管溶血及检测结果的影响

The Effect of Different Blood Drawing Methods on Hemolysis and Test Results from Intravenous Catheters Used in Emergency Departments.

作者信息

Kazezoglu Cemal, Serin Erdinc

出版信息

Clin Lab. 2019 Jan 1;65(1). doi: 10.7754/Clin.Lab.2018.180614.

DOI:10.7754/Clin.Lab.2018.180614

PMID:30775901

Abstract

BACKGROUND

Hemolysis is frequently reported in samples sent from emergency departments. In our study we aimed to compare the influence of invitro hemolysis on test results and hemolysis ratios of different blood drawing techniques (aspiration method and vacuum filling technique) used to draw blood from intravenous (IV) catheters in Emergency Department. Two techniques (aspiration vs. vacuum filling) used to draw blood into three different tubes (Sarstedt S-Monovette® 4.9 mL Serum Gel tube, BD 5 mL Vacutainer® Rapid Serum Tube (RST), and 5 mL Vacutainer® SST™II tube) and evaluated the effect of the hemolysis index of the sera on the tests analyzed.

METHODS

In the emergency department blood was drawn from 128 consecutive patients into Sarstedt S-Monovette® 4.9 mL Serum Gel tubes using aspiration technique and also into BD 5 mL Vacutainer® Rapid Serum Tubes (RST) and 5 mL Vacutainer® SST™II tubes using vacuum filling technique. All the tests requested from the patients were analyzed on all tubes and the hemolysis index of all the tubes were also evaluated.

RESULTS

As a result, the percentage of hemolysis encountered in S-Monovette® vs. SST and S-Monovette® vs. RST was 4.41% vs. 14.71% and 0% vs. 18.97%, respectively (p < 0.001, p < 0.001). In addition to this, the mean values of the test results for each assay in S-Monovette® tubes showed a significant difference when compared to RST and SST (p < 0.01). CKMB and LDH test results found in the tubes filled using the aspiration techniques (S-Monovette®) were statistically significantly lower than the results gathered from the tubes filled using vacuum filling technique (Vacutainer® RST and Vacutainer® SST) (p < 0.001).

CONCLUSIONS

The test results and HI taken from the aspiration method seemed to be more reliable despite the presence of hemolysis.

摘要

背景

急诊科送检样本中经常出现溶血情况。在我们的研究中，我们旨在比较体外溶血对检验结果的影响，以及急诊科用于从静脉导管抽血的不同采血技术（抽吸法和真空采血技术）的溶血率。将两种技术（抽吸法与真空采血法）用于采集血样至三种不同的试管（Sarstedt S-Monovette® 4.9 mL血清凝胶管、BD 5 mL Vacutainer®快速血清管（RST）和5 mL Vacutainer® SST™II管），并评估血清溶血指数对所分析检验的影响。

方法

在急诊科，连续128例患者的血液分别采用抽吸技术采集至Sarstedt S-Monovette® 4.9 mL血清凝胶管中，同时采用真空采血技术采集至BD 5 mL Vacutainer®快速血清管（RST）和5 mL Vacutainer® SST™II管中。对所有患者所需的所有检验项目在所有试管上进行分析，并评估所有试管的溶血指数。

结果

结果显示，S-Monovette®管与SST管、S-Monovette®管与RST管的溶血百分比分别为4.41%对14.71%、0%对18.97%（p < 0.001，p < 0.001）。除此之外，S-Monovette®管中每项检测的检验结果平均值与RST管和SST管相比存在显著差异（p < 0.01）。采用抽吸技术（S-Monovette®管）采集的试管中检测到的CKMB和LDH检验结果在统计学上显著低于采用真空采血技术（Vacutainer® RST管和Vacutainer® SST管）采集的试管中获得的结果（p < 0.001）。