2023 年第 7 期 第 18 卷

检验科急诊组危急值的回顾性分析与评估

Retrospective analysis and evaluation of critical value in the emergency group of department of clinical laboratory

作者：杨郝亮1张萍2武利涛1周航宇1郝金莉1丁然1陈维华1张梅1杨曦明1

英文作者：Yang Haoliang1 Zhang Ping2 Wu Litao1 Zhou Hangyu1 Hao Jinli1 Ding Ran1 Chen Weihua1 Zhang Mei1 Yang Ximing1

单位：1北京中医药大学东直门医院检验科，北京100700；2北京市通州区疾病预防控制中心，北京101100

英文单位：1Department of Clinical Laboratory Dongzhimen Hospital Beijing University of Chinese Medicine Beijing 100700 China; 2Tongzhou District Center for Disease Control and Prevention Beijing 101100 China

关键词：危急值；急诊检验；重症监护单元

英文关键词：Criticalvalue;Emergencylaboratory;Intensivecareunits

• 摘要：

• 目的  分析北京中医药大学东直门医院检验科急诊组危急值报告现状，为危急值报告制度的持续改进提供科学依据。方法  收集2018年12月至2021年11月北京中医药大学东直门医院检验科急诊组危急值报告的原始数据，分析各危急值项目发生率、危急值科室分布、项目分布及危急值时间分布情况。结果  2018年12月至2021年11月检验科急诊组共报告危急值19 235件，占所有检测件数（1 140 285件）的1.69%。2019年（2018年12月至2019年11月）、2020年（2019年12月至2020年11月）、2021年（2020年12月至2021年11月）不同年份危急值发生率分别为1.48%（7 007/473 124）、1.78%（5 304/297 318）和1.87%（6 924/369 843）。2019—2021年危急值的发生率逐年升高。危急值报告前5位科室为血液肿瘤科、肾病内分泌科、重症监护病房、急诊科及心脏重症监护室，前5位科室的件数占危急值总件数的72.86%（14 015件）。2019—2021年危急值项目报告件数占前5位的分别是血尿素氮、血小板计数、血肌酐、白细胞计数和纤维蛋白原。2019—2021年危急值发生件数周一最多，周日最少。2019年危急值发生率春冬季高，2020年危急值发生率春夏季高，2021年危急值发生率秋冬季高。结论  通过回顾性分析危急值发生情况，实验室可持续改进危急值报告制度，从而更好地保障患者生命安全。

• Objective  To analyze the current status of critical values reporting in the emergency group of Department of Clinical Laboratory, Dongzhimen Hospital, Beijing University of Chinese Medicine and provide scientific basis for the continuous improvement of critical values reporting system. Methods  From December 2018 to November 2021, the raw data of critical value report in the emergency group of Department of Clinical Laboratory, Dongzhimen Hospital, Beijing University of Chinese Medicine were collected, and the occurrence rate, department distribution, project distribution and time distribution of critical value items were analyzed. Results  From December 2018 to November 2021, 19 235 critical values were reported in the emergency group of department of clinical laboratory, representing 1.69% of all tested items (1 140 285). Incidence rates of critical values in different years of 2019 (December 2018 to November 2019), 2020 (December 2019 to November 2020) and 2021 (December 2020 to November 2021) were 1.48%（7 007/473 124）, 1.78%（5 304/297 318） and 1.87%（6 924/369 843）, respectively. The incidence of critical value increased year by year from 2019 to 2021. The top 5 departments of the critical value report were the department of hematology and oncology, the department of nephrology and endocrinology, the department of intensive care unit, the department of emergency and the department of cardiac intensive care unit. The number of cases in the top 5 departments accounted for 72.86% (14 015) of the total number of critical value cases. From 2019 to 2021, the top 5 critical values were blood urea nitrogen, platelet count, serum creatinine, white blood cell count and fibrinogen. From 2019 to 2021, the number of critical value occurrences was highest on Monday and the lowest on Sunday. The incidence of critical values was high in spring and winter in 2019, high in spring and summer in 2020, and high in autumn and winter in 2021. Conclusion  Through retrospective analysis of the occurrence of critical values, the laboratory can continuously improve the critical values reporting system, so as to better protect the safety of patients.