中国血液净化

›› 2010, Vol. 9 ›› Issue (10): 534-537.doi: 10.3969/j.issn.1671-4091.2010.10.004

• 临床研究 • 上一篇    下一篇

持续质量改进在减少腹膜透析患者腹膜炎发生中的作用

武 蓓 王 梅 赵慧萍 芦丽霞 乔 婕   

  1. 北京大学人民医院肾内科
  • 收稿日期:2010-08-18 修回日期:1900-01-01 出版日期:2010-10-12 发布日期:2010-10-12
  • 通讯作者: 王梅

Effect of continuous quality improvement on the prevention of peritonitis in continuous ambulatory peritoneal dialysis patients

WU Bei, WANG Mei, ZHAO Hui-ping, LU li-xia, QIAO Jie   

  1. Department of Nephrology, Peking University People’s Hospital, Beijing 100044, China
  • Received:2010-08-18 Revised:1900-01-01 Online:2010-10-12 Published:2010-10-12

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摘要：

目的 探讨应用持续质量改进(continuous quality improvement, CQI)的方法降低腹膜透析患者腹膜炎发生率的效果。方法 选择北京大学人民医院腹膜透析中心CQI前(2008年)持续不卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者63例，分析腹膜炎(29例次)的发生率及特征，采用设计、实施、检验和应用(plan, do, check and act, PDCA)四步法，设计并实施减少腹膜炎发生的防治措施，与CQI后2009年同期101例CAPD患者腹膜炎(14例次)发生情况比较。结果 CQI后，我中心CAPD患者腹膜炎发生率明显降低，由1次/22.2患者月降至1次/70.4患者月。其中，革兰氏阳性球菌所致腹膜炎发生率由1次/35.8患者月降至1次/197患者月；复发性腹膜炎发生率由1次/80.5患者月降至1次/985患者月。与CQI中主要采取的几项改进措施相一致。结论 CQI的方法可以降低腹膜透析中心腹膜炎发生率。

关键词: 腹膜透析, 腹膜炎, 持续质量改进

Abstract:

【Abstract】 Objective To evaluate the effect of continuous quality improvement (CQI) on the prevention of peritonitis in CAPD patients. Methods Thirty peritonitis cases in the 63 CAPD patients in 2008 were analysis. We adopted the four-step method (PDCA), i.e., plan, do, check and act, to design and perform measures for reducing the prevalence of peritonitis, and then compared the peritonitis patients in 2008 with the 14 peritonitis patients in 101 CAPD patients in 2009. Results After CQI, peritonitis patients reduced obviously, from 1 case every 22.2 months to 1 vase every 70.4 months. Gram-positive coccobacteria peritonitis patients reduced from 1 case every 35.8 months to 1 case every 197 months. Recurrent peritonitis reduced from 1 case every 80.5 months to 1 case every 985 months. The decrease of peritonitis cases coincided with the measures we adopted. Conclusion CQI can reduce he prevalence of peritonitis in CAPD patients.

Key words: Peritonitis, Continuous quality improvement