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Problems of vacuum tube blood collection and Realization of full automation of blood collection

2023年02月10日

Since the invention of vacuum tube in 1940s, manual blood collection has been adopted. After collecting the use evaluation of medical staff, it is considered that the following technical disadvantages need to be solved:

1. The vacuum setting is affected by atmospheric pressure, and it is difficult to correct accurately due to different altitudes. Therefore, it is difficult to achieve the standard by comparing the blood collection volume with the standard measuring tool.

2. There is residual negative pressure: due to the large negative pressure set in the vacuum tube, when the difference between the actual sample collection and the pressure set in the test tube is large, the nurse will pull out the needle in advance after reaching the scale when changing the tube. In this way, there will be residual negative pressure of varying degrees in the previous test tube, resulting in the gas in the blood cells overflowing outside the cell wall and the cell structure being damaged.

3. It is impossible to judge whether the puncture is successful: because the puncture plug end of the two-way needle is equipped with a rubber sheath, it is difficult to judge whether the puncture is successful when there is no blood return after puncture into the vein, which can only be judged by the operator's personal feeling and experience. In traditional syringe blood collection, when the needle enters the blood vessel, it can determine whether the puncture is successful or not by back pumping, but vacuum blood collection can not be solved by back pumping. Therefore, skilled technology and experience are required for blood collection of poor filling and small blood vessels.

4. Manual tube replacement requires two hands operation, and hands cannot be released to fix the blood collection needle. During tube replacement, the needle inserted into the vein will move, resulting in the accident that the blood collection needle falls out of the blood vessel, resulting in the failure of blood collection, which is easy to cause doctor-patient disputes.

5. After blood collection, the nurse needs to mix the samples manually. It must be mixed after the unified collection of multi tube blood. At this time, the patients in the hypercoagulable state have micro coagulation. If the blood is not mixed carefully immediately after in vitro, the number of unqualified samples in blood routine and coagulation will increase, resulting in error in the test results.

6. There is a safety risk of blood backflow in the body: when the atmospheric pressure in the test tube is higher than the venous pressure after the vacuum tube is exhausted, the risk of blood backflow has been reported in foreign cases. At present, test tubes abroad are sterilized, and sterilized vacuum tubes are gradually promoted in China, but the manufacturing cost is increased.

With the application of laboratory automation equipment and the requirements of clinical data informatization, it is urgent to develop fully automated blood collection equipment to speed up the blood collection speed and reduce the system disadvantages caused by manual operation. The vacuum collector has always followed the mode of prefabricated vacuum, prefabricated labeling and prefabricated filling of additives in the factory. After the test tube leaves the factory, with the extension of storage time, the liquid additives in the test tube will overflow out of the test tube through the test tube wall, resulting in the reduction of the volume of additives and affecting the correct mixing ratio of blood and additives. In addition, The negative pressure of plastic test tubes will gradually decrease with the extension of storage time, resulting in inaccurate blood sample volume, resulting in inaccurate test results and delaying the diagnosis of patients. The continuous high-pressure aerosol injection method is used to inject additives in the factory, and the inaccurate metering is also one of the influencing factors.

With the popularization and use of large analytical instruments in hospital laboratory, hospital information management system (his) and laboratory information management system (LIS), bar code real-time printing and pasting technology has been carried out in major hospitals across the country, but most of them use manual printing and pasting. At present, there is no relevant literature or equipment at home and abroad about the integrated equipment of instant automatic selection of test tubes, automatic instant filling of additives, instant vacuum extraction, instant automatic printing of bar code labels and pasting on test tubes, and then automatic blood collection.

Due to the large amount of outpatient blood collection and many blood samples in large hospitals, they are eager to quickly process the blood samples for computer analysis after blood collection. Because the blood collection vessels are not automatically classified according to the requirements, the blood samples that need centrifugation are selected and then automatically balanced and centrifuged, and then sent to the laboratory. The blood samples are immediately taken for analysis and test without pre-treatment. At present, there is no equipment for automatic sorting of blood collection vessel types and automatic centrifugation in medical device exhibitions and hospitals. Traditional centrifuges are vertical or inclined at an angle of 45 degrees. One test tube needs to be put into the centrifugal cylinder and then withdrawn after centrifugation. Before centrifugation, the weight balance of the centrifugal tubes on both sides needs to be carried out, which not only delays time, but also affects the speed. The most difficult problem to solve is how to put or take out the blood collection vessel as a whole, automatically balance the weight on both sides of the centrifuge tube, and automatically open and close the cover of the centrifuge. In addition, if the test tube is taken out after centrifugation, careless operation will cause the secondary mixing of serum and blood cells and failure.

7. The negative pressure curve of vacuum blood collection vessel is a slide type and is in a declining state. The weakening of negative pressure suction near the end of blood collection can lead to patients with high blood viscosity and hyperlipidemia unable to draw the standard scale, resulting in insufficient blood collection.

8. High test tube cost: in order to keep the vacuum for a long time, the vacuum tube needs high-density materials and high cost. If the temporary preparation of vacuum and the filling of additives can significantly reduce the cost, which is in line with the general direction of the development of medical reform.