Rose V L, Dermott S C, Murray B F, McIver M M, High K A, Oberhardt B J
Center for Thrombosis and Hemostasis, University of North Carolina, Chapel Hill.
Arch Pathol Lab Med. 1993 Jun;117(6):611-7.
Previous work has established the precision and accuracy of a portable blood coagulation analysis system using paramagnetic particles contained in a dry reagent on a disposable test card. We examined the deployment of this technology in decentralized hospital settings and compared test results obtained in the surgical intensive care unit, coronary care unit, and outpatient cardiology clinic with those obtained in the central laboratory. Nursing personnel were instructed in the use of the system, and quality control testing was performed daily by the laboratory staff. In the intensive care units, patient subjects included those on whom tests of prothrombin time and activated partial thromboplastin time had been ordered. Immediate determinations were performed by the intensive care unit nursing staff on the same citrated, whole-blood samples that were subsequently sent to the central laboratory. In the outpatient cardiology clinic, fingerstick blood samples were obtained for prothrombin time determinations with the dry chemistry system. Paired prothrombin time samples obtained by venipuncture were run in the hospital laboratory. The study involved multiple users, multiple locations, two lots of activated partial thromboplastin time cards, and several different instruments, over an extended period. Correlation coefficients between the dry chemistry system and the hospital laboratory under these conditions were in an acceptable range in all sites studied. We concluded that, with appropriate training and quality assurance, the dry chemistry system provides an acceptable alternative to the hospital laboratory for prothrombin time and activated partial thromboplastin time determinations.
先前的研究已证实，一种便携式血液凝固分析系统具有高精度和准确性，该系统使用一次性测试卡上干试剂中所含的顺磁性颗粒。我们研究了这项技术在医院分散科室的应用情况，并将在外科重症监护病房、冠心病监护病房和门诊心脏病诊所获得的测试结果与在中心实验室获得的结果进行了比较。对护理人员进行了该系统使用方面的培训，实验室工作人员每天进行质量控制检测。在重症监护病房，患者对象包括那些已被要求进行凝血酶原时间和活化部分凝血活酶时间检测的患者。重症监护病房的护理人员对相同的枸橼酸盐全血样本进行即时检测，随后将这些样本送往中心实验室。在门诊心脏病诊所，采集手指血样本，使用干化学系统进行凝血酶原时间测定。通过静脉穿刺获得的配对凝血酶原时间样本在医院实验室进行检测。该研究涉及多个用户、多个地点、两批活化部分凝血活酶时间测试卡以及数台不同的仪器，且持续了较长时间。在所有研究地点，在这些条件下干化学系统与医院实验室之间的相关系数均在可接受范围内。我们得出结论，经过适当培训和质量保证后，干化学系统可为医院实验室进行凝血酶原时间和活化部分凝血活酶时间测定提供可接受的替代方法。
