測定前の諸問題 総論 測定前問題の解消なしには正しいデータは得られない

摘要

Clinical laboratory staff should provide laboratory data showing or reflecting the exact patho-physiological conditions of patients or examinees (exact data). Intralaboratory quality management and assurance have been improved to satisfactory levels; however, preanalytical processes have been poorly checked and the situation is still unsatisfactory. The improvement of preanalytical issues is essential to provide exact data. Among various issues affecting the data, inadequate sampling has been and will be the major problem to be tackled by laboratory staff. In blood collection, more than 90% of samples are collected by nurses and most urine, feces and sputum are collected by patients themselves. To improve the current situation, regular meetings with other hospital staff and providing information on clinical laboratory medicine are possible ways to make them aware of current problems. Two examples are presented: the clinical laboratory practice of medical students in Fukushima Medical University and the Clinical Laboratory Forum held in 1991~1999, which was performed in collaboration with Fukushima Associations of Nurses, Medical doctors and Laboratory technician and laboratory staff of Fukushima Medical University.Additionally, the effect of freezing and thawing at different temperatures were compared for 30 biochemical items. About half of individual sera showed reduced levels of ALT and LD when frozen at -20 and thawed at 25 compared with those frozen at -80C and thawed at 37C.