Recently, many people have asked questions about how blocking holes are mostly handled by stubborn holes, and they all ask whether they are related to reagents, and all the questions involved in the consultation involve several manufacturers' reagents with a large sales volume. The following is a detailed explanation:
1. The occurrence of all plugging holes is related to the correct operation of the blood collection method. It is very easy to carry a large number of epithelial cells or cotton fibers to plug the holes. It is also difficult to eliminate. Sometimes, large diameter holes may see cotton and other substances. Many hospitals like the F820 have seen a large group of cotton wool rushing out of the hole when recoiling. This is a good example. Most automatic and semi-automatic problems are mostly found in pre-dilution specimens. Whole blood specimens are almost No.
2. There is a problem with anticoagulation, or that the anticoagulation ratio is not correct (too high will cause satellite phenomenon, many small cells in the surrounding satellites of large cells can be seen under the microscope, causing the cells to be large and difficult to dissolve), and the storage time is too short. This is also one of the reasons, which is also an important reason for testing poor platelet destabilization in 25 minutes. EDTA anticoagulants and thrombocytic clotting factors take time to react, which is shortened with increasing temperature. This is The cause of the problem is likely to occur when the weather gets cold.
3, coagulation and mixing, blood coagulation, mixing is not good, anticoagulant use is not correct (such as sodium citrate, oxalic acid and other non-blood anticoagulants will lead to long-term use of hole blocking), which must have been known.
It is clear to all these commonsense things that these situations have not been mastered or dealt with at the time. It would not result in blocking holes at the time or after the completion of the specimen, but there will be a cumulative time, and the above situations will occur many times. There are several mechanisms below:
4, WBC channel plugging mechanism: hemolysis problems, hemolysis is the main reason, it is important to note that the lack of significant hemolysis will show an increase in HGB and WBC rise, it is easy to warn people, here is a slight hemolysis Insufficient, the WBC and HGB do not see the numerical change or very slight, there will be an irregular rising curve in the lymphatic peak before the WBC graph, this will cause enough vigilance, generally this kind of situation appears, within 30 days Severe plugging can occur. The main reason is that the haemolysis agent destroys the incomplete red blood cells or the adhesion and aggregation of red blood cell debris. This will continue for a long time and it will adhere to the small holes. The attachment of these cell debris and protein deposition on the small holes will be like building a house of cement. The thicker and thicker the layer by layer, it is difficult to clear the suspicion that it may be plugged and concentrated cleaning is done. Diluent problem, the physical and chemical indicators of the diluent is not qualified, resulting in cells can not be properly diluted interval, the free will cause cell aggregation, showing obvious in the histogram, but the problem of plugging holes often can not see the problem in the histogram, The reason is that when changing the reagents, the corresponding sensitivity and gain adjustments are made, and the calibration coefficients are also adjusted accordingly. Thus, the problem cannot be seen on the histogram. The replacement of the diluent with a slightly better physical and chemical index will result. It is important to notice the obvious changes in the histograms. These reagents are often the products of manufacturers with very small sales areas. There are not many sales hospitals, and the maintenance of the equipment is also covered by the warranty itself.
5. Rupture mechanism of RBC channels: Blood samples are diluted by tens of thousands of times and then counted in the red cell counting cell for resistance. There is no other reagent intervened in the diluent during dilution. It is known that the leukocyte pool can reduce the interference of some proteins and fragments by the action of the hemolyzing agent, and is often a sample in which leukocytes are distributed and is mixed with a hemolyzing agent and bubbles before it begins to be distributed and diluted in the red cell pool. Simultaneously with the red cell pool, the red cell pool's protein fragment suspension activity is higher than that of the white cell pool, and the ratio of these proteins and debris is also higher than that of the white blood cell pool. This is the main reason for red blood cell plugging. the reason.
6, lack of negative pressure, some people say that negative pressure will alarm. To know that the instrument alarm circuit has a range of long-term negative pressure limit, or that adjusting the negative pressure alarm limit will lead to the actual negative pressure. The reasons for the lack of negative pressure to plug the hole are well understood. We all know that tap water is supplied by water pumps to provide enough pressure to supply millions of households. We have not heard that the tap water pipeline will be blocked or there are any attachments on the inner wall of the pipeline. However, the sewers are often Relying on the natural height, the speed of the water flow is naturally low, which provides good conditions for the attachment of the inner wall of the sewage pipeline. Therefore, everyone sees that the dirt on the inner wall of the sewage pipeline is very thick. In the Hematology Analyzer, insufficient negative pressure will provide favorable conditions for the attachment of proteins and debris to the small holes. Therefore, the monitoring and adjustment of the negative pressure and the emptying pressure are generally better at the upper limit, so that there is more room left. It is often said that the small hole is not blocked, I have handled and inspected, and I am absolutely sure, but why is it that blocking holes or phenomena is blocking holes? The most frequently asked question before this is F820, which is actually caused by insufficient negative pressure.
