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foreword
forewordAs we all know, chyle blood samples will affect the test results of some items of blood routine, and it is difficult to quickly identify the samples with the naked eye without centrifugati.
case after
case afterApril 12, 2022, night shift, when I was holding a specimen to review the biochemical results, I saw a sample with severe lipid turbidi.
diagnosis
figure 1
figure 1RBC: 37×10^12/L, HGB: 140g/L↓, MCHC: 360g/L↑, did not trigger the sample review prompt dialog box formulated by our laboratory, see Figure
figure 2
figure 2Chylous blood does not seriously interfere with blood routine, and HGB and MCHC are only slightly elevat.
image 3
image 3Calculated by the formula, HGB correction value = before HGB correction - HGB lipid blood plasma (1 - before HCT correction), MCH correction value = HGB correction value / before RBC correction; MCHC correction value = HGB correction value / before HCT correcti.
Figure 4
Figure 4Due to the lax operation, there is a big difference between the results of HGB plasma exchange and the corrected resul.
Figure 5
Figure 5The original results, formula correction and plasma exchange results are compared in the following table:
case analysis
case analysisThe detection principle of hemoglobin is colorimetry [1]
[1] [2]
In this case, the results of the biochemical test report are shown in Figure
Image 6
Image 6The test principle of this instrument is different from that of conventional biochemical instrumen.
In this normal saline plasma exchange, the author made several mistakes, which led to a large deviation in the replacement resul.
The influence of chyle blood on the test results is not serious, and mild to moderate lipidemia has almost no effect on the test results of HCB [3]
[3]
In addition, it is not necessary to perform three times of saline replaceme.
[3]
The inspector can comprehensively analyze whether the sample is disturbed by the chyle blood sample according to the alarm information of the instrument, the ratio of MCHC, RBC and HGB,e.
Conditional hospitals can also include this alarm in the historical system and prompt when reviewing sampl.
experience
experienceAfter this case, the value of MCHC>384g/L that needs to be re-examined when reviewing specimens formulated by the department may need to be slightly adjust.
[references]
[references][1] Liu Chengyu, Editor-in-Chief Luo Chun.
[1] Liu Chengyu, Editor-in-Chief Luo Chun.
[2] Feng Xuezh.
[3] Luo Xuelin, Lin Faqu.
Comparison of plasma exchange method and formula correction method on the correction of hemoglobin results in chyle blood specimens [.
PLA Preventive Medicine Journal , 2019, 37(8): 161-16
