2015年至2019年住院患者临床标本不合格原因及对策分析

Causes and Counter Measure Analysis of Inpatients Unqualified Clinical Specimens from 2015 to 2019.

作者信息

Huang Yuzhu, Mei Siqing, Dai Wen, Ma Jinqu, Li Yan, Zhang Ping-An

出版信息

Clin Lab. 2021 Mar 1;67(3). doi: 10.7754/Clin.Lab.2020.200619.

DOI:10.7754/Clin.Lab.2020.200619

PMID:33739052

Abstract

BACKGROUND

To improve the quality of pre-analytical phase and provide targeted suggestions, this study analyzed factors causing unqualified clinical specimens in patients of the Department of Clinical Laboratory of Renmin Hospital of WuHan University from 2015 to 2019.

METHODS

Inpatient specimens from January 2015 to December 2019 were retrospectively analyzed. Unqualified specimens were identified by referring to the general principle of rejection. The analytical indicators included incidence rate of unqualified specimens and constituent ratio of reasons of unqualified specimens. These two indicators were analyzed according to the inpatient wards and types of specimens.

RESULTS

From 2015 to 2019, 21,674 inpatient unqualified specimens were collected, the incidence rate of unqualified specimens was 0.22% (21,674/9,700,869), the number and rate of unqualified specimens decreased year by year. The main reasons of unqualified specimens were insufficient volume (29.67%, 6,430/21,674) and clotting (26.31%, 5,703/21,674). The number of unqualified specimens in the departments of cardiovascular, pediatrics, neurology, oncology, urinary surgery, and intensive care unit ranked the top each year. Clotting (39.29%, 5,682/14,462) was the main reason of unqualified blood specimens while insufficient volume (71.18%, 3,365/4,727) was for urine specimens. Wrong identification caused unqualified feces (62.65%, 728/1,162) and body fluid (40.74%, 539/1,323) specimens.

CONCLUSIONS

Clinical laboratory could make effective measures to improve pre-analytical quality by retrospectively analyzing data of unqualified specimens.

摘要

背景

为提高分析前阶段的质量并提供针对性建议，本研究分析了2015年至2019年武汉大学人民医院临床检验部患者临床标本不合格的原因。

方法

回顾性分析2015年1月至2019年12月的住院患者标本。参照拒收的一般原则确定不合格标本。分析指标包括不合格标本发生率及不合格标本原因构成比。这两个指标按住院病房和标本类型进行分析。

结果

2015年至2019年，共收集到21674份住院患者不合格标本，不合格标本发生率为0.22%（21674/9700869），不合格标本数量和发生率逐年下降。不合格标本的主要原因是采血量不足（29.67%，6430/21674）和凝血（26.31%，5703/21674）。心血管内科、儿科、神经内科、肿瘤科、泌尿外科和重症监护室每年的不合格标本数量位居前列。凝血（39.29%，5682/14462）是血液标本不合格的主要原因，而采血量不足（71.18%，3365/4727）是尿液标本不合格的主要原因。标识错误导致粪便标本（62.65%，728/1162）和体液标本（40.74%，539/1323）不合格。