[1]喻 雕a,胡 兰b,胥世朋a,等.临床实验室甲状腺功能检测项目应用西格玛度量运行大小列线图设计多阶段质量控制策略[J].现代检验医学杂志,2023,38(02):190-193+199.[doi:10.3969/j.issn.1671-7414.2023.02.036 ]
　YU Diaoa,HU Lanb,XU Shi-penga,et al.Using Sigma-metric SQC Run Size Nomogram to Design a Multistage Quality Control Strategy for Thyroid Function Testing Items in Clinical Laboratory[J].Journal of Modern Laboratory Medicine,2023,38(02):190-193+199.[doi:10.3969/j.issn.1671-7414.2023.02.036 ]
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临床实验室甲状腺功能检测项目应用西格玛度量运行大小列线图设计多阶段质量控制策略()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年02期
页码:
190-193+199
栏目:
质量控制?实验室管理
出版日期:
2023-03-15

文章信息/Info

Title:
Using Sigma-metric SQC Run Size Nomogram to Design a Multistage Quality Control Strategy for Thyroid Function Testing Items in Clinical Laboratory
文章编号:
1671-7414（2023）02-190-05
作者:
喻 雕a; 胡 兰b; 胥世朋a; 曾 玲a
（毕节市第一人民医院 a.检验科；b.消化内科，贵州毕节 551700）
Author(s):
YU Diaoa; HU Lanb; XU Shi-penga; ZENG Linga
（a. Department of Clinical Laboratory；b. Department of Gastroenterology, the first People’s Hospital of Bijie City, Guizhou Bijie 551700, China）
关键词:
甲状腺功能; 列线图; 多阶段质量控制; 风险管理
分类号:
R446
DOI:
10.3969/j.issn.1671-7414.2023.02.036
文献标志码:
A
摘要:
目的 基于患者风险设计甲状腺功能检测项目的多阶段质控策略。方法 利用国家卫生健康委员会临床检验中心内分泌室间质评回报结果和日常质控数据获得偏移百分差和室内质控变异系数，并计算西格玛（σ）度量值。估算实验室甲状腺功能检测项目的最大日工作量和期望报告间隔，应用 σ度量运行大小列线图设计甲状腺功能检测项目的质控程序并在实验室内运行 1周，计算质控开支占总成本的比例。结果 促甲状腺激素（thyroid stimulating hormone，TSH）、游离三碘甲状原氨酸（free T3，FT3）、游离甲状腺素（free T4，FT4）、三碘甲状原氨酸（total triiodothyronine，TT3）和甲状腺素（total thyroxine，TT4）的 σ度量值分别为 6.06，3.68，4.36，4.35和 2.28。TSH的起始质控程序为 13s N2，监控质控程序为 13s N1；FT3和 TT4的起始质控程序为 MR N4，监控质控程序为 MR N4；FT4和 TT3起始质控程序均为 MR N2，监控质控程序均为 13s N2。运行 1周质控程序， TSH和 TT3未监测到失控点， FT4监测到 1个失控点， FT3监测到 4个失控点， TT4监测到 2个失控点。 TSH，FT4，TT3，FT3和 TT4的质控开支占总成本的比例分别为 3.3%，5.3%，5.3%，10.3%和 10.3%。结论 应用西格玛度量运行大小列线图设计甲状腺功能检测项目的多阶段质量控制策略可以降低患者伤害的风险。
Abstract:
Objective To design a multistage quality control strategy for thyroid function testing items based on patient risk. Methods The bias was obtained from the results of the endocrine external quality assessment of the National Center for Clinical Laboratories, and the coefficient of variation of the internal quality control was obtained from the daily quality control data, and then the sigma metrics value was calculated. Estimating the laboratory’s maximum daily workload and expected reporting interval for thyroid function testing, applied the sigma metric to run the nomogram to design quality control procedures for thyroid function testing items and was run in the laboratory for 1 week, and calculate the proportion of quality control expenses to total costs. Results The σ metrics values of TSH，FT3, FT4, TT3 and TT4 were 6.06, 3.68, 4.36, 4.35 and 2.28, respectively. The initial quality control program for TSH was 13sN2, and the monitoring quality control program was 13sN1.The initial quality control for FT3 and TT4 was MR N4, and the monitoring quality control was MR N4. The initial quality control for FT4 and TT3 was MR N2, and the monitoring the quality control was 13sN2. After running the quality control program for 1 week, TSH and TT3 did not detect out of control point, FT4 detected 1 out of control point, FT3 detected 4 out of control points, and TT4 detected 2 out of control points .The proportion of quality control expenses in TSH, FT4, TT3, FT3 and TT4 to the total cost was 3.3%, 5.3%, 5.3%, 10.3% and 10.3%, respectively. Conclusion Applying σ metrics to run size nomograms to design and analyze multistage quality control strategies for projects can minimize the risk of patient harm.

参考文献/References:

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备注/Memo

备注/Memo:
收稿日期：2022-06-11 修回日期：2023-01-03
基金项目：毕节市联合基金 [毕节联合字 sy（2002）1号 ]：婴幼儿肺炎 25羟维生素 D水平及免疫相关因素的研究。
作者简介：喻雕（1989-），男，硕士，主管技师，主要从事临床实验室质量管理， E-mail:yd15559629286@163.com。

更新日期/Last Update: 2023-03-15