Moraglio D, Banfi G
Laboratorio di Analisi Chimico-Cliniche e Microbiologia, Ospedale Civile SS. Annunziata, Savigliano, Italy.
Scand J Clin Lab Invest. 1996 Dec;56(8):735-42. doi: 10.3109/00365519609088821.
The control of preanalytical variables is critical, particularly for coagulation assays, since this has a direct influence on the quality of results and on their clinical reliability. The aim of the study was to evaluate the extent of information about preanalysis in the laboratories of a large region of northern Italy that perform tests of haemostasis. A questionnaire was sent concerning the number of coagulation analyses per year, the system of blood drawing, the anticoagulants and the tubes in use, the amount of blood collected, the tendency to reject unsuitable specimens, the storage temperatures, the times between collection and analysis, the conditions of tube centrifugation and identification, and the presence of staff specifically occupied in coagulation testing. Complete answers were offered by 136 laboratories (81%; 69 private and 67 public) that reported a total amount of 3,648,000 determinations per year. Statistical analysis was carried out on the findings of the investigation, in order to assess their significance and to detect possible correlations between the variables under consideration. The results show significant attention being given by laboratories to the preanalytical phase. This is also indicated by the large percentage of complete answers obtained. Some of the important positive aspects shown in the study are: (1) the preference for the closed system for blood sampling; (2) the prevalent use of primary tubes for testing; (3) a strong tendency to reject incorrect samples for analysis. On the other hand, a major problem seems to lie in the delay, particularly in some big centres, in processing of specimens, which can be critical for the correct performance of coagulation assays. The data obtained reflect with good reliability the overall situation in coagulation-testing laboratories in northern Italy.
分析前变量的控制至关重要，对于凝血检测而言尤其如此，因为这直接影响结果的质量及其临床可靠性。本研究的目的是评估意大利北部一个大区进行止血检测的实验室中有关分析前情况的信息范围。发送了一份问卷，内容涉及每年的凝血分析数量、采血系统、使用的抗凝剂和试管、采集的血液量、拒收不合适标本的倾向、储存温度、采集与分析之间的时间、试管离心和识别条件，以及专门从事凝血检测的工作人员情况。136个实验室（81%；69个私立和67个公立）提供了完整答案，这些实验室报告每年总共进行3648000次检测。对调查结果进行了统计分析，以评估其重要性并检测所考虑变量之间可能存在的相关性。结果显示实验室对分析前阶段给予了高度关注。获得的完整答案比例很高也表明了这一点。该研究显示的一些重要积极方面包括：（1）对封闭式采血系统的偏好；（2）普遍使用原管进行检测；（3）强烈倾向于拒收用于分析的不合格样本。另一方面，一个主要问题似乎在于标本处理的延迟，尤其是在一些大中心，这对于凝血检测的正确进行可能至关重要。所获得的数据很好地可靠反映了意大利北部凝血检测实验室的总体情况。
