实验诊断学(英文版)第一章PPT格式课件下载.ppt

实验诊断学(英文版)第一章PPT格式课件下载.ppt

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Chapter1GeneralofClinicalLaboratoryLIPingGeneralofclinicallaboratoryPrinciplestoclinicallaboratoryTheinterpretationoflaboratorytestsTheethicalpracticePrincipletoclinicallaboratoryResponsibilitiesCollectionofInformationCollectionofSpecimens（Informedconsent、Adequateprivacy）PerformanceofTestReportingofResultStorageandRetentionofMedicalRecordsAccesstoMedicalRecordsResponsibilitiesThepatient-assurancethequalityandintegralityoftheserviceColleagueandprofessional-maintainprofessionalreputation,aimtocontributetheadvancementofprofessionSociety-contributetothegeneralwell-beingofsociety;@#@complywithrelevantlawsandregulationsofprofessionalactivities.CollectionofinformationIdentifyadequatelypatientsandspecimensEnablethetesttobecorrectlyinterpretedOtherlegitimatepurposesPerformanceofthetestAccreditationprogramPatientsinterestsProcessstandardWorkswithhighskillandcompetenceGoodperformanceoftestsReportingofResultTestresultsareconfidentialunlessdisclosureisauthorized.ReporttheresultscorrectlyandtimelyProvidetheconsultationabouttheselectionandinterpretationoftestsproperlyAccesstoMedicalRecordsclinicianrequestingthetest;@#@thepatient;@#@laboratoryandhospitalstaffifrequiredforthemanagementofthepatient;@#@otherauthorizedindividuals.Whenarequestismadeforaccesstotestresultsbyanauthorizedperson,thelaboratorymustfirstsatisfyitselfastotheidentityofthepersonmakingtherequest.Who?

@#@INTERPRETLABORATORYTESTSelecttestPatientsprepareforsamplingCollectspecimenPre-processofspecimenAnalyzespecimenCheck、reportresultMakeclinicaldecisionBiologicalvariability,improperorinconsistentpreparationImproperorinconsistantCollectionImproperprovisionsuboptimumselectionAnalyticalvariabiltyInadequateRVsMinimizevariabilityNoconfusionandmisunderstandingabouttestresultsTestingCycleBiologicvariatinonEndogenousbiorhythmsforphysiologicparametersDifferentconstitutionalfactorsandlifestyleamongsubjectswithin-subjectvariationsubject-tosubjectvariationBiologicalvariationWidthofthetestsReferencinterval（RI）thediagnosticefficiencyofalaboratorytestlBiologicalrhythmslConstitutionalfactorslExtrinsicfactorsThreetypesofBiologicalrhythmsCircadianRhythmsUltradianRhythmsInfradianRhythmsCycletime24h24hCharacterConsistentPredictableInconsistentUnpredictableunknowsolutionrhythm-adjustedRVsstimulationandsuppressiontestsunknowexampleNumberandactivityofbloodcellgonadalhormonemenstrualcycleBiologicvariationendogenousbiorhythmsforphysiologicparametersDifferentconstitutionalfactorsandlifestyleamongsubjectswithin-subjectvariationsubject-tosubjectvariationBiologicalvariationWidthofthetestsReferencinterval（RI）thediagnosticefficiencyofalaboratorytestlBiologicalrhythmslConstitutionalfactorslExtrinsicfactorsBiologicvariabiltyConstitutionalfactorinfantschildrenadultselderlyrapidphysiologicchanges、hemolysis、bilirubinPlasmaproteinenzymesexhormonesconstantuntilmenopauseinwomenandmiddleageinmenage-relateddifferencesinnutrition、intercurrentdiseaseAgespecificreferencelimitsageAgeBiologicvariabiltyConstitutionalfactorGeneticheterogeneityphenotypicdifferencesDifferentconcentrationofanalyteDifferentreactivitytowardsnucleicacidprobesandantibodiesfalse-negativeMisleadingGeneticheterogeneityBiologicvariabilty-ExtrinsicFactorsvascularinterstitialspacesupinestandH2OSmallanalyteplasmavolumeConcentrationofnondiffusiblanalytehomeostasisofvasculartonerenninaldosteronecatecholaminesPostureBiologicvariabiltyExtrinsicFactorsshiftsinplasmawaterglomerularfiltrationrateurineproductionreleaseofmacromoleculesfromcellsandtissuesExerciseBiologicvariabilty-ExtrinsicFactorsmealrelatedfastingrelatedlRecommendation:

@#@durationoffastingbeforespecimencollectionistypically12hoursTGTCBUNGLU.LacAcetoneGlucagons.DietBiologicvariabiltyExtrinsicFactorsTypesofInterferenceAnalyticalinterferencePhysiologicinterferenceRecommendationRecognizedrugspotentialforoccurrence,withdrawmedicationsbeforesamplingwheneverpossible,Evaluatanysuspiciousresultsinlightofasubjectsmedicationhistory.DrugBiologicvariabilty-ExtrinsicFactorsplasmavolumeerythrocytemassplasmaproteinsynthesisaltereddistributionofcardiacoutputendocrinologicchangeshyperventilationPregnancyBiologicvariation-summaryBiologicalrhythmsCircadian,Ultradian,InfradianrhythmsConstitutinalfactorsGender,age,geneExtrinsicfactorsPosture,Exercise,Diet,Drugs,Pregnancy,Caffeine,Alcoholuse,OralContraceptives,IntercurrentIllnessEstablishandvalidateRVsEstablishclinicalperformancecharacteristicsWhy?

@#@lHelpcliniciantoselectthemosteffectivetestsandtestingstrategieslHelpcliniciantotranslatelaborator