CAJ | 학술논문

目的：了解焦作地区医疗机构供血库ABO血型鉴定存在的问题，不断规范并提高检测水平，确保临床输血安全。方法①选择正常A、B、O、AB型标本各1份，A2B、A3、Bend、Ax、ABx、Bm亚型标本各1份，分别对16家医疗机构供血库进行ABO血型鉴定现场质量测评。要求各供血库随机指定工作人员，采用日常工作使用的试验方法进行检测，并填写统一发放的试验记录表格。②测评者同步观察整个试验过程，详细记录发现的问题。③针对存在问题制定改进措施。结果①16家供血库对4份正常血型标本鉴定的准确率均为100.0%，对6份亚型标本的鉴定存在不同程度的漏检和误判。②亚型标本漏检、误判的原因，与工作人员亚型理论知识不足、试剂质量、试验方法局限性、操作不规范、质量控制薄弱等因素有关，其中工作人员亚型理论知识不足和质量控制薄弱是16家供血库均存在的问题。③采取针对性改进措施后，供血库ABO亚型的检测水平大幅度提高。结论血站以指导、提高为目的，用亚型标本对医疗机构供血库进行ABO血型鉴定现场质量测评,并根据发现问题采取对应措施，能显著提高供血库ABO亚型检出率，进一步保障临床患者特别是亚型患者的输血安全,具有一定的科学性、实用性和有效性。
목적：료해초작지구의료궤구공혈고ABO혈형감정존재적문제，불단규범병제고검측수평，학보림상수혈안전。방법①선택정상A、B、O、AB형표본각1빈，A2B、A3、Bend、Ax、ABx、Bm아형표본각1빈，분별대16가의료궤구공혈고진행ABO혈형감정현장질량측평。요구각공혈고수궤지정공작인원，채용일상공작사용적시험방법진행검측，병전사통일발방적시험기록표격。②측평자동보관찰정개시험과정，상세기록발현적문제。③침대존재문제제정개진조시。결과①16가공혈고대4빈정상혈형표본감정적준학솔균위100.0%，대6빈아형표본적감정존재불동정도적루검화오판。②아형표본루검、오판적원인，여공작인원아형이론지식불족、시제질량、시험방법국한성、조작불규범、질량공제박약등인소유관，기중공작인원아형이론지식불족화질량공제박약시16가공혈고균존재적문제。③채취침대성개진조시후，공혈고ABO아형적검측수평대폭도제고。결론혈참이지도、제고위목적，용아형표본대의료궤구공혈고진행ABO혈형감정현장질량측평,병근거발현문제채취대응조시，능현저제고공혈고ABO아형검출솔，진일보보장림상환자특별시아형환자적수혈안전,구유일정적과학성、실용성화유효성。
Objective To understand the problems of ABO identification the blood banks of medical institutions in Jiaozuo area, regulate continuely and improve the level of the detection, ensure the safety of clinical blood transfusion. Methods ①One copy of each normal A, B, O, AB sample and one copy of each A2B, A3, Bend, Ax, ABx, Bm hypotype sample were chosen. Then the ABO identifications 16 blood banks of medical institution were respectively conducting on-site quality evaluated. Each blood-bank randomly assigned to staff member using the daily work testing methods, and filled the unified payment trial record form. ②The reviewers observed simultaneously throughout the trial, and record the detailed problems. ③Formulate improvements measuresfor the existing problems. Results ①The accuracy rate of identification for four normal blood sample in the 16 blood banks was 100.0%, but there were different degrees of undetected and false positives for the 6 subtypes. ②The reasons of undetected and false positives for the subtypes was related to the lack of subtype theory knowledge, reagent quality, limitations of testing methods, unstandardized op-erations, weaked quality control and other factors. The lack of subtype theory knowledge of the staffs and weaked quali-ty control were the problems for all the 16 blood banks.③After taking targeted improved measures, the level of the de-tection for ABO subtypes was greatly improved. Conclusion The purpose of blood-banks is guiding and improving, so using subtypes to conduct on-site quality evaluation of ABO identifications, and taking corresponding measures in ac-cordance with the problems can significantly improve the detection rate for ABO subtype, and further protect the safety of blood transfusion in clinical especially the patients of subtype. All of these have functions of some scientific, practi-cal and effective.