临床检验项目危急值复查价值探讨

摘要

目的 探讨临床检验项目危急值复查价值.方法 提取我院2015年1~10月脑钠肽前体(proBNP)、肌红蛋白(myoglobin)、高敏肌钙蛋白T(hs-cTNT)和降钙素原(PCT)危急值结果,对这些危急值的初始检测结果和重复测试结果进行统计,计算标本重复试验延迟时间,并核算复查所需要的成本.结果 发现proBNP、myoglobin、hs-cTNT和PCT初始结果与复查值中分别仅有0.05%、0.22%、0.1%和0.1%标本存在显著性差异,且显著性差异原因来自于实验前;复查造成的时间延迟从11~25 min不等;因危急值复查,ProBNP项目成本增加8.19%,myoglobin项目成本增加4.54%,hs-cTNT项目成本增加3.30%,PCT项目成本增加4.46%.结论 在保证检测体系稳定性和避免标本干扰前提下,临床检验项目一次检测直接发出结果,由临床医生结合临床表现是否予以复查,将节约成本、增加抢救时间.%Objective To explore the repeat-testing value of critical value of clinical examination item. Methods The critical value results of pro-brain natriuretic peptide (proBNP), myoglobin, high-sensitive cardi-ac troponin T (hs-cTnT) and procalcitonin (PCT) of patients, who admitted to our hospital from January 2015 and October 2015, were extracted and compared. The first-testing results and repeat-testing results of the criti-cal values were calculated to estimate the delay time for repeat-testing of the samples and the cost for re-peat-testing. Results Between first-testing and repeat-testing results, there was significant difference in 0.05%, 0.22%, 0.1% and 0.1% of the samples for proBNP, Myoglobin, hs-cTNT and PCT respectively, and the reason of the difference mainly came from pre-experiment. The delay time caused by the repeat-testing ranged from 11 minutes to 25 minutes. As the results of the critical value repeat-testing, the project cost increased by 8.19%, 4.54%, 3.30% and 4.46% for proBNP, myoglobin, hs-cTNT, PCT, respectively. Conclusion Under the premise that the detection system stability is guaranteed and specimen interference is avoided, the clinical doc-tors are recommend to decide whether to re-check the results based on the clinical primary examination and clin-ical presentation, which can reduce costs and save rescue time.