Raisky F, Gauthier C, Marchal A, Blum D
Laboratoire de biologie, CHG Louis-Pasteur, France.
Ann Biol Clin (Paris). 1994;52(7-8):523-7.
The haemolysis of blood samples is a source of error in the electrolytic and enzymatic determination in clinical biochemistry. This circumstance seems dependent on the material used for the venepuncture. In this study we compared three kinds of material in 350 patients who were sampled in the emergency department. This randomized study compared the haemolysis of blood samples collected with stainless steel needles and short catheters, either Teflon FEP (Cathlon Critikon) or polyurethane Vialon (Insyte Becton-Dickinson). Quantification of hemolysis was performed by assay of the optical density of plasma haemoglobin. Results were analysed, after verification of the randomization, by one-way analysis of variance by ranks. This study demonstrated a highly significant relation between occurrence of haemolysis and the sampling material, used according to its technical obligations. Haemolysis occurred frequently when short catheters were used in 42% and 55% of cases with the Teflon and Vialon catheters, respectively. Haemolysis was much less frequent with stainless steel needles (12%). This difference was even more marked for haemoglobin levels above 1.5 milligrams of plasma, where the incidence was 4.2%, 9% and 30%, respectively, for the stainless steel needles, the Teflon catheter and the Vialon catheter. This study induced our emergency department to take more blood samples with a needle, even if an infusion was to be given subsequently, or to take them using a Teflon catheter.
血液样本的溶血是临床生物化学中电解和酶法测定误差的一个来源。这种情况似乎取决于静脉穿刺所使用的材料。在本研究中,我们在急诊科对350例患者比较了三种材料。这项随机研究比较了用不锈钢针和短导管(聚四氟乙烯FEP导管(Cathlon Critikon)或聚氨酯Vialon导管(Insyte Becton-Dickinson))采集的血液样本的溶血情况。通过测定血浆血红蛋白的光密度对溶血进行定量。在验证随机化后,通过秩次单向方差分析对结果进行分析。本研究表明,根据技术要求使用的采样材料与溶血的发生之间存在高度显著的关系。使用短导管时溶血频繁发生,使用聚四氟乙烯导管和Vialon导管的病例中分别有42%和55%出现溶血。使用不锈钢针时溶血频率要低得多(12%)。对于血浆血红蛋白水平高于1.5毫克的情况,这种差异更为明显,不锈钢针、聚四氟乙烯导管和Vialon导管的发生率分别为4.2%、9%和30%。这项研究促使我们急诊科即使随后要进行输液,也更多地用针采集血样,或者使用聚四氟乙烯导管采集血样。