摘要
目的调查武汉市血液透析单位的质控数据并分析总结,提出改进措施。方法武汉市血液透析质量控制中心对40家血液透析单位进行年度血液透析质控检查,包括对各透析单位的透析水质内毒素集中检测,同时对各血液透析单位的质量核心数据(key performance indicators,KPI)进行采集汇总分析,包括血管通路、血红蛋白(hemoglobin,Hb)、血浆白蛋白(albumin,Alb)、血钙、血磷、血甲状旁腺素(parathyroid hormone,PTH)等各项指标。结果武汉市40家血液透析单位的水质采样内毒素检测中,26家单位(65%)的4种样本内毒素同时达标,其余单位部分超标,总体导管占比为22.22%,有93.9%的单位导管占比>10%。Hb、Alb、血钙、血磷、iP TH的总体达标率分别为54.69%、81.08%、65.24%、41.17%、47.52%,平均值分别为(98.77±5.91)g/L、(37.47±7.12)g/L、(2.22±0.09)mmol/L、(1.77±0.52)mmol/L、(299.8±156.43)ng/L。结论武汉市血液透析总体水平与国内水平类似,需加强对各透析单位血液透析的质量控制,进一步提高武汉市血液透析水平。
Objective To investigate and analyze the data of quality control of hemodialysis units in Wuhan city,and propose countermeasures. Methods The Hemodialysis Quality Control Center of Wuhan city carried out the annual investigation of 40 hemodialysis units,including the centralized endotoxin detection of dialysis water in each hemodialysis unit. Simultaneously,the dialysis quality data of each dialysis unit were collected and analyzed,including vascular access,hemoglobin（ Hb）,serum albumin（ Alb）,serum calcium（ Ca）,phosphorus（ P） and parathyroid hormone（ PTH）,etc. Results Among the 40 hemodialysis units,endotoxin detection in 4 samples reached a set standard in 26 units（ 65%）,and the rest units exceeded the standard to varying degrees. All units reached the set standard after rectification. The overall catheter ratio was 22. 22%,and 93. 9% of units exceeded the standard. The reaching standard rate of Hb,Alb,Ca,P and iP TH was 54. 69%,81. 08%,65. 24%,41. 17% and 47. 52%,and the average values of them were（ 98. 77 ± 5. 91） g/L,（ 37. 47 ± 7. 12） g/L,（ 2. 22 ± 0. 09） mmol/L,（ 1. 77 ± 0. 52） mmol/L,and（ 299. 8 ± 156. 43） ng/L respectively. Conclusions The overall level of hemodialysis in Wuhan was similar to that of domestic level,and the quality control of hemodialysis units should be strengthened to further improve the level of hemodialysis in Wuhan.
出处
《临床肾脏病杂志》
2017年第8期461-465,共5页
Journal Of Clinical Nephrology
基金
2016年武汉市卫计委项目武汉地区血液透析规范化研究(No.WG16D15)
