[1]程秀丽,王 琴,李 巍,等.Westgard西格玛多规则方法在临床血液学检验常规项目质控中的应用[J].现代检验医学杂志,2018,33(05):151-154.[doi:10.3969/j.issn.1671-7414.2018.05.042]
　CHENG Xiu-li,WANG Qin,LI Wei,et al.Application of Westgard Sigma Rules in Routine Clinical Hematology Tests[J].Journal of Modern Laboratory Medicine,2018,33(05):151-154.[doi:10.3969/j.issn.1671-7414.2018.05.042]
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Westgard西格玛多规则方法在临床血液学检验常规项目质控中的应用()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第33卷
期数:
2018年05期
页码:
151-154
栏目:
质量控制·实验室管理
出版日期:
2018-11-18

文章信息/Info

Title:
Application of Westgard Sigma Rules in Routine Clinical Hematology Tests
文章编号:
1671-7414(2018)05-151-04
作者:
程秀丽; 王 琴; 李 巍; 阚鹏程; 杨 萍
天津市神经外科研究所天津市脑血管病和神经变性重点实验室/天津市环湖医院医学检验科,天津 300350
Author(s):
CHENG Xiu-li; WANG Qin; LI Wei; KAN Peng-cheng; YANGPing
Department of Clinical Laboratory,Tianjin Key Laboratory of Cerebral Vessels and Neural Degeneration,Tianjin Neurosurgical Institute,Tianjin Huanhu Hospital,Tianjin 300350,China
关键词:
六西格玛;  Westgard西格玛多规则;  血细胞计数;  凝血试验
分类号:
R446
DOI:
10.3969/j.issn.1671-7414.2018.05.042
文献标志码:
A
摘要:
目的 应用Westgard西格玛多规则定量分析临床实验室全血细胞计数及凝血项目检测性能,帮助实验室建立最优Westgard质控规则。方法收集天津市环湖医院参加卫生部临床检验中心2017年全国全血细胞计数及凝血试验室间质量评价结果,以各项目靶值百分差值的均值作为偏倚估计值,以室内质控长期累积在控变异系数作为不精密度估计值,以卫生行业标准WS/T 406-2012中的允许总误差作为质量规范,利用检验医学信息网提供的软件计算西格玛度量值和绘制西格玛性能验证图,确定最适Westgard质控规则。结果 参与质评的全血细胞计数中,包括白细胞计数、红细胞计数、血红蛋白、红细胞压积、血小板计数、红细胞平均体积、平均血红蛋白含量和平均血红蛋白浓度在内的8个检测项目均达到世界一流水平(σ>6),建议选择13s(N=2,R=1)作为质控规则。凝血试验中,凝血酶原时间和纤维蛋白原表现良好(σ>4),活化部分凝血活酶时间检测性能可接受(3<σ<4),建议选择多个质控规则组合的方式以提高误差检出率。结论 Westgard西格玛多规则方法可以有效地应用于临床血液学检验的质量管理,针对特定检测项目设置最优Westgard质控规则。
Abstract:
Objective To establish the optimal Westgard rules for clinical laboratory with Westgard Sigma Rules that was used to quantitatively analyze the performance of routine clinical hematology tests.Methods Data were collected from the results of national whole blood cell counts and coagulation tests of clinical hematology.The mean percentage difference in external quality assessment(EQA)of each item was calculated as the estimation of bias and the accumulative in-control coefficient of variation(CV)ofinternal quality control(IQC)was recognized as imprecision.The total allowable errors derived from the health industry standard WS/T 406-2012 as quality specification.Sigma values and Sigma Quality Assessment Chart were obtained from the software provided in the Clinet network and the optimal Westgard rules were determined.Results All of the eight blood cell counts tests reached the sigma value above 6,ranked into the top of the world and could choose the 13s(N=2,R=1)rule.Among the three coagulation tests,PT and Fib got the sigma value with σ>4 and APTT with 3<σ<4,a combination of rules should be selected to increase the detection of errors.Conclusion Westgard Sigma Rules could be effectively applied into the quality management of routine clinical hematology measurements,and help laboratoriesto establish the quality control procedure on the sigma scale.

参考文献/References:

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备注/Memo

备注/Memo:
作者简介:程秀丽(1986-),女,博士研究生,主管技师,研究方向:临床检验质量控制,E-mail:chengxl890_beauty@126.com。
通讯作者:杨 萍(1962-),女,主任技师,E-mail:tjhhhospitallab@126.com。
更新日期/Last Update: 2018-09-30