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临床医师对外周血标本进行常规血液检测的应用调查分析。

Investigation and analysis on the application of peripheral blood specimens for routine blood testing by laboratory physicians.

机构信息

Central Laboratory, Guangzhou Panyu District Central Hospital, Guangzhou, China; Department of Laboratory Medicine, Guangzhou Panyu District Central Hospital, Guangzhou, China.

Department of Laboratory Medicine, Guangzhou Panyu District Central Hospital, Guangzhou, China.

出版信息

Ann Palliat Med. 2021 Sep;10(9):9516-9522. doi: 10.21037/apm-21-2068.

Abstract

BACKGROUND

Owing to its simplicity, speed, small incision, and low cost, peripheral blood collection is widely used in routine blood testing. However, there are certain differences between the detection results of peripheral and venous blood specimens. This investigation and analysis aimed to investigate and analyze the status and opinions of laboratory physicians on the application of peripheral blood for routine blood testing.

METHODS

A questionnaire was used to investigate and analyze the current status of laboratory physicians with regards to routine peripheral blood testing. The content of the questionnaire included the following aspects: the proportion of peripheral blood specimens, the difficulty of detecting peripheral blood, factors affecting the results of peripheral blood specimens, the proportion of the simultaneous detection of blood test and C-reactive protein (CRP), as well as the proportion and ideals of hypersensitive CRP (hs-CRP), which included a total of 10 re-examination rules.

RESULTS

Laboratory physicians from 410 hospitals participated in the investigation. The proportion of routine blood tests using peripheral blood specimens in the laboratory departments of tertiary hospitals was low (P=0.006). Difficulties in routine blood tests with peripheral blood specimens were dominated by insufficient blood volume (67.8%). The factors affecting the results of routine blood tests with peripheral blood specimens were dominated by the mixing method (86.6%). When abnormal results were determined by routine blood tests using peripheral blood specimens, they were retested most commonly by making slide smears (82.4%) or re-examined using the remaining peripheral blood (66.1%). The same rules for re-examination of peripheral and venous blood were applied in most medical institutions (86.1%). When the platelet count decreased in routine blood tests using peripheral blood samples, the most common measures included sample agglutination checks (88.5%), instrument alarm message checks (82.4%), and making slide smears for re-examination (73.6%). More laboratory physicians expected blood analyzers to be integrated instruments that could provide both routine blood and hs-CRP testing (80.5%).

CONCLUSIONS

There are numerous difficulties in routine blood testing using peripheral blood, and thus, more convenient and accurate blood analysis instruments should be developed.

摘要

背景

由于外周血采集具有简便、快速、切口小、成本低等优点,在常规血液检测中得到了广泛应用。然而,外周血和静脉血标本的检测结果存在一定差异。本研究旨在调查分析检验科医师对末梢血用于常规血液检测的应用现状和意见。

方法

采用问卷调查的方式,对检验科医师进行末梢血常规检测现状进行调查分析,问卷内容包括末梢血标本比例、末梢血检测难度、影响末梢血标本结果的因素、血常规与 C 反应蛋白(CRP)同时检测的比例、超敏 CRP(hs-CRP)的比例及理想值,共包括 10 条复查规则。

结果

共有 410 家医院的检验科医师参与调查。三级医院检验科末梢血常规检测标本比例较低(P=0.006)。末梢血常规检测困难主要以血量不足为主(67.8%)。影响末梢血常规检测结果的因素主要以混匀方式为主(86.6%)。当末梢血常规检测结果异常时,最常进行的复查方法为制作血涂片(82.4%)或复查剩余末梢血(66.1%)。大多数医疗机构外周血和静脉血的复查规则相同(86.1%)。末梢血血小板计数减少时,最常采取的措施包括样本凝集检查(88.5%)、仪器报警信息检查(82.4%)和制作血涂片复查(73.6%)。更多的检验科医师希望血液分析仪能成为集常规血液和 hs-CRP 检测于一体的仪器(80.5%)。

结论

末梢血常规检测存在较多困难,应开发更便捷、准确的血液分析仪器。

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