检验科建设与管理(摘要）
现代医学中，实验室的检查在诊断工作中起着重要作用，提供了重要的客观诊断依据，在一些疾病中甚至有决定性的意义。从诊断学中逐步独立出来的一个新的学科——实验诊断学，是涉及各专业学科的一门边缘学科，也是运用基础医学的理论和技术为临床医学服务的学科。它不仅在疾病诊断和患者治疗上起着至关重要的作用，同样在判断疾病预后及治疗疗效方面，是较好的客观指标。近年来国外越来越多采用“Laboratory Medicine”作为本学科的名称，检验医学是指对临床标本进行正确地收集和测定，并作出正确的解释和应用。这有两个方面含义：一个是实验室技术，现在医院实验室早已不限于使用显微镜，已使用了各种先进仪器，除了广泛应用自动化技术外，还用了激光、色谱分析、质谱分析、荧光分析、流式细胞术、DNA扩增技术等一系列高精尖的技术手段，所以从事检验医学应该有扎实实验室技术工作的理论基础和高超的技术，否则，无法提供准确和及时的报告。另一方面要有扎实的医学理论和实践经验才能正确地对各种检验结果作出合理和恰当的解释。二十一世纪将是科学技术，特别是生物科学迅速发展的时代，随着生命的奥妙不断被揭示，将会有更多更新的技术应用于临床医学和检验医学，作为工作场所的检验科毫不疑问将在这方面起着越来越重要的作用。检验科如果仍保持像目前”自动化仪器”工厂的形象，不重视”继续教育”，将有可能丢弃自己阵地，降低自己的地位，这在中国检验界早有深刻教训。只有不断掌握先进技术，将自己形象改为”学习中心”，表现为一直在不断接受最新技术和方法，以及”诊断专家”的地位，才能在二十一世纪不仅保持而且加强检验医学在医学中的地位和重要性，才能有所发展。二十一世纪检验医学将掌握人类最先进技术，特别是分子诊断学技术，能开展上万项检验项目，在这种情况下检验科工作者特别是检验医师义不容辞担负起咨询服务工作，为临床提供检验结果的合理解释和应用，积极参加临床上的疾病管理和结果分析。只注重技术教育不注重医学教育显然不能适应二十一世纪需要。
在现代医学技术突飞猛进和社会医疗保障体制改革的今天，人们对医院的质量越来越予高度的关注，因为质量是医院生存与发展的基础和根本。科学技术特别是计算机和生物技术的进步，检验医学无论从内容上还是技术上都得到了迅速发展和完善。现在已经利用血生化仪、细胞计数仪、PCR仪等先进仪器设备对人体进行全方位化验检查，为疾病的诊断、治疗、预防和保健提供了可靠的依据。检验报告的正确与否，关系着受检者的健康安危，检验质量更是检验科业务技术建设的生命线。但是在检验医学实验室的管理上，目前还存在一些问题。主要是缺乏切实可行的质量控制体系；内部管理滞后，工作人员技术机械化、思维惰性化；管理者还未真正认识到自己在学科发展中的地位和作用，在管理的方法上还存在着一定的缺陷。因此，加强检验科的质量控制，科学评价检验科质量水平是当前面临的共同课题。
供应链管理是企业采用的一种新的管理模式。它开始于供应的源点，结束于消费的终点，跨越了企业界线，从扩展企业的新思维出发，以全局和整体的角度来考虑竞争力。随着我国医疗市场竞争的日益激烈，患者需求的不确定性和个性化增加以及检验技术的迅猛发展，医院检验科在不断规范和完善内部管理的同时，更应注意外部的需求及变化，以提升自身的竞争力。将这种管理模式应用到医院检验科上，以提高检验科的管理效率，不失为一种新的尝试。
In modern medicine,the examination in a laboratory plays an important role in our diagnostics as it provides a crucially objective standard of diagnostics.For some diseases,it even acts as an decisive element.A new discipline-laboratory diagnosis,which has diverged gradually from diagnostics science,is a dual discipline that concerns with all kinds of specialized subjects,also one which applies theories of basic medicine and technology to serve clinical medicine.It is critical in the diagnostics and treatment of a disease as well as a good objective index to prognosis and therapeutic effect of the disease.Recently,more and more foreign countries prefer to adopting “Laboratory Medicine” as the title of this discipline. Laboratory Medicine means collecting and measuring clinical samples correctly and giving right explanation and appliance.So its annotation is expressed in two aspects:On the one hand,it is a sort of laboratory technology.As we all knows,nowadays hospitals haven’t long been restricted to the use of a microscope.Instead,besides automatic technology widely used,a series of advanced technology such as laser,MS,IF,flow cytometry,DNA amplification have been widely applied.So people engaged in the work of laboratory medicine should have a solid basis of theories about laboratory technological work and master the superb technique.Otherwise,it’s impossible for him to present precise and timely reports;on the other hand ,he is also expected to have a sound basis of medical theories and experiences in order to explain a wide variety of results reasonably and appropriately.The 21th century is an epoch in which science and technology,especially biology develop dramatically.With the revealing of mysteries of life,more and newer technology will be applied to clinical and laboratory medicine.Therefore,as a workplace, the department of laboratory medicine will certainly become more and more significant in this respect.However,if it remains its current image of the factory of automatic instruments and keeps blind to the importance of further education,the department will lose its status and degrade itself inevitably.Only by mastering advanced technology,altering its image to “center of study”which keeps absorbing the latest technology and methods, remains to be the expert of diagnosis, the department of laboratory medicine can maintain,even strengthen the status and importance of laboratory medicine in medicine.The 21th century will master human most advanced technology,particularly molecular diagnosis.And thousands of examination items can be carried out.Under the circumstances,the workers of this field,especially laboratory doctor should commit the work of consulting service without any hestitation and supply the advisable explanation and appliance of the examiation report to clinical medicine.At the same time,they are also expected to actively attend disease management and outcome analysis.Consequently,just emphasizing technological education instead of medical one can’t obviously meet the requirements of 21th century because medical education is a dispensible element.
