中国血液净化

中国血液净化 ›› 2015, Vol. 14 ›› Issue (03): 152-154.doi: 10.3969/j.issn.1671-4091.2015.03.00

• 临床研究 • 上一篇    下一篇

持续质量改进对维持性血液透析患者血红蛋白水平的影响

蒋飞,蔡美顺,王梅,左力,甘良英,杨冰,赵新菊,王磊,燕宇,王宓,韦洮,隋准   

  1. 北京大学人民医院肾内科(蒋飞，现在重庆三峡医药高等专科学校工作)
  • 收稿日期:2014-11-14 修回日期:2014-12-18 出版日期:2015-03-12 发布日期:2015-04-20
  • 通讯作者: 蔡美顺 cai_meishun@163.com E-mail:cai_meishun@126.com

Effect of continuous quality improvement on hemoglobin level in maintenance hemodialysis patients

  • Received:2014-11-14 Revised:2014-12-18 Online:2015-03-12 Published:2015-04-20

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摘要： 【摘要】目的 探讨通过持续质量改进(Continues quality improvement，CQI)在改善维持性血液透析(maintenance hemodialysi，MHD)患者的血红蛋白(Hb)水平的作用及方法。 方法 选择北京大学人民医院2006年1月～2013年12月的维持性血液透析临床数据完整的患者共299例，以慢性肾脏病及透析的临床指南(NKF-K/DOQI及KDIGO指南)中关于肾性贫血的处理指南为原则，应用CQI的PDCA四步法，对患者的Hb进行质量管理，观察比较每年所有MHD患者平均Hb水平、Hb达标率及达标次数比率情况变化。 结果 2006年96人平均Hb水平为(105.0±18.6)g/L，Hb达标率为37.5%；204次Hb检查中达标次数比率为41.7%。通过CQI，2011年109人平均Hb水平达(111.1±10.3)g/L (P=0．000)；2011年1147次Hb检查中达标次数比率达59.9% (P=0．000)；2013年152人Hb达标率达61.8% (P=0．000)。 结论 采用CQI方法可改善维持性血液透析患者的血红蛋白水平，对于维持性血液透析患者的并发症的管理有较重要意义。

关键词: 持续质量改进, 血液透析, 血红蛋白

Abstract: 【Abstract】Objective To explore the effect of continuous quality improvement (CQI) strategy on hemoglobin (Hb) level in maintenance hemodialysis (MHD) patients. Methods A total of 299 MHD patients treated in Hemodialysis Center of Peking University People's Hospital from Jan. 2006 to Dec. 2013 and with complete clinical data were enrolled in this study. The PDCA, a 4-step problem-solving frame work of CQI based on NKF-K/DOQI and KDIGO guidelines, was used for the management of Hb level in MHD patients. Average Hb level, proportion and frequency of patients with targeted Hb level were compared every year. Results In 2006, average Hb was 105.0±18.6 g/L, Hb level reached the target level was 37.5% in 96 MHD patients, and the frequency of Hb level reached the target level was 41.7% in 204 Hb measurements. After the performance of CQI strategy, average Hb increased to 111.1±10.3 g/L in 109 patients (P=0.000) in 2011, Hb level reached the target level was 61.8% in 152 MHD patients (P=0.000) in 2013, and the frequency of Hb level reached the target level was 59.9% in 1147 Hb measurements (P=0.000) in 2013. Conclusions The implementation of CQI strategy resulted in the increase of Hb level in MHD patients and was thus useful for the management of anemia complication in MHD patients.

Key words: Continues quality improvement, hemodialysis, hemoglobin