臨床檢驗報告自動驗證模式之研究-自動尿液試紙分析與顯微鏡人工判讀

The Study of Autoverification for Automated Urinalysis with the Corresponding Manual Microscopic interpretations

鄒佳君(Chia-Chun Tsou)

指導教授 ： 劉建財

臺北醫學大學/醫學院/醫學資訊研究所/碩士(2010年)

https://doi.org/10.6831/TMU.2010.00014

摘要

隨著臨床實驗室開始導入精實化管理(Lean)，加上自動分析儀也開始朝檢驗項目整合方向發展，實驗室人員與儀器的運用不再受制於所謂專業分組，希望以更少的人員、同時使用更多台儀器，以更少時間，處理更多項目檢驗檢查與不同種類的檢體，為達到這目標，實驗室務必要將檢驗結果自動驗證流程廣泛應用於越來越多檢驗項目上。檢驗結果自動驗證的設定，其困難點不僅在於需要一定的資訊硬體系統以及一定的資訊內容，而是規則該依據哪些條件來設定？尿液常規檢查檢驗項目可以篩檢腎臟、輸尿管、膀胱或尿道的病變，是醫院中最常做的檢驗項目之一，以醫學中心來看，平均每天大約要分析300~800件以上的尿液檢體；尿液常規檢驗包括儀器分析半定量數值與人員判讀兩種檢驗結果，需要以人工逐筆執行報告覆閱後才可將報告發出；受限於現今臨床檢驗報告自動驗證所提出的方法僅限於數值型，且以生化檢驗項目為主，對於尿液常規檢驗這一類包含半定量數值的檢驗報告，目前並無較好的自動驗證流程設計可供利用。本研究利用尿液常規檢驗具相關性項目的絕對正確範圍、試劑容許偏差範圍、累計容許偏差範圍，做為報告結果值自動驗證的依據，建立臨床實驗室尿液常規檢驗項目報告自動驗證流程。運用此方式，人工覆閱報告比率為14~16%，相較於實驗室原先100%人工覆閱報告比率以及10~15%重取檢體分析比率，本研究所提出的驗證範圍設計方式更有效率，估計每天可省下花在執行尿液常規檢驗作業約100~200分鐘。

關鍵字

自動驗證 ； 半定量 ； 尿液常規檢驗

並列摘要

By implementing lean in clinical laboratories, autoverification has to be more widely applied in order to improve operational efficiency. The difficulty in setting up the autoverification process is not only the need for certain hardware and data, but also which criteria should be chosen. What are valid factors in setting up the autoverification rules? The routine urinalysis, one of the widely ordered tests, including automated analysis semi-quantitative results and microscopic reading results, all the reports need to be verified case by case manually. It is difficult to design the autoverification process of semi-quantitative reports follow the rules of numeric reports like biochemical examination.

並列關鍵字

autoverification ； semi-quantitative ； urinalysis

參考文獻

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