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基于二项分布的统计过程控制方法在血液质量控制中的应用研究

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目的 通过引入统计过程控制(SPC)方法,分析去白细胞悬浮红细胞的质量控制项目,以期在血液质量控制数据的有效应用方面取得进展,并为血液质量的持续改进提供循证依据。方法 自2020-2022年,收集了重庆地区6家血站的去白细胞悬浮红细胞质量控制项目检测数据。利用Minitab软件进行统计过程控制分析,绘制p控制图,计算各质控项目的不符合率及其95%置信区间,以及过程能力指数(Z值)。结果 根据《全血及成分血质量要求》对去白细胞悬浮红细胞的质量控制项目进行评估,得出外观、储存期末溶血率、无菌试验符合率均为100%。然而,容量、血红蛋白含量、血细胞比容、白细胞残留量的符合率未能达到100%,但均≥75%。通过基于二项分布的p控制图,进一步识别了生产过程的受控状态。在总体符合率满足国标要求的情况下,发现容量、血红蛋白含量、血细胞比容、白细胞残留量在不同机构中存在失控点,并呈现出明显的趋势。各质控项目的不符合率虽均小于25%,但在95%置信水平下,B、C、E、F,4家血站的白细胞残留量显示不符合规定(>25%)。通过构建能力评价指标Z值进行计数资料的过程能力分析,结果显示E机构的容量,以及B、C、F机构的血细胞比容和全部6家血站的白细胞残留量Z值均<2,提示存在质量改进的空间。结论 基于二项分布的统计过程控制方法,对血液成分质量控制具有较好的应用价值,能够进一步实现对血液采集、制备和储存过程的实时监控和过程改进。
Application of binomial distribution-based statistical process control method in blood quality control
Objective This study endeavors to introduce the statistical process control(SPC)method to analyze the quality control index concerning red blood cells in additive solution with leukocytes reduced,with the aspiration to advance the effective utilization of blood quality control data,thereby providing empirical foundations for the continual enhancement of blood quality.Methods Between 2020 and 2022,test data pertaining to the quality control index of red blood cells in additive solution with leukocytes reduced were amassed from six blood stations in Chongqing area.Utilizing Minitab software,the SPC analysis was carried out,p-control charts were delineated,the non-conformance rates of each quality control index along with their 95%confidence intervals were computed,as well as the Process Capability Index(Z value).Results In accordance with the Whole Blood and Blood Components Quality Requirements,the appraisal of the quality control indexes for red blood cells in additive solution with leukocytes reduced manifested a conformity rate of 100%for appearance,end-of-storage hemolysis rate and sterility test.Nonetheless,the conformity rates for volume,hemoglobin,hematocrit and residual leukocytes did not attain 100%,albeit all were ≥75%.Through the employment of binomial distribution-based p-control charts,the controlled state of the production process was discerned.Although the overarching conformity rate satisfied the national standard stipulations,it was discerned that there were out-of-control points concerning volume,hemoglobin,hema-tocrit,and residual leukocytes across different institutions,exhibiting palpable trends.The non-conformance rates of all quality control indexes were less than 25%,yet at a 95%confidence level,the residual leukocyte counts from institutions B,C,E,and F did not adhere to the stipulations(exceeding 25%).By architecting the ability evaluation index Z value for count data process capability analysis,it was unveiled that the volume of institution E,the hematocrit of institutions B,C,and F,and the residual leukocytes Z values of all six blood collection and supply institutions were below 2,hinting at avenues for amelioration.Conclusion The SPC method anchored in binomial distribution exhibits substantial application merit in blood component quality management,facilitating real-time surveillance of blood collection,preparation,and stor-age procedures.

statistical process controlblood quality controlbinomial distributiontrend analysis

刘星辰、代华友、杨俊鸿、崔丹荔、吴思其、尹鹏为、黄霞、徐永柱

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重庆医科大学公共卫生学院,重庆 400016

重庆市血液中心

统计过程控制 血液质量控制 二项分布 趋势分析

中国输血协会威高科研基金项目重庆市科卫联合医学科研重点项目重庆市卫生健康委医学科研项目

CSBT\WG-2021-062022ZDXM0312024WSJK062

2024

中国输血杂志
中国输血协会 中国医学科学院输血研究所

中国输血杂志

CSTPCD
影响因子:1.279
ISSN:1004-549X
年,卷(期):2024.37(2)
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