持续质量改进对纠正血液透析患者高磷血症的作用

Effect of continuous quality improvement on hyperphosphatemia management in hemodialysis patients

目的通过持续质量改进（CQI）的方法纠正血液透析（HD）患者的高磷血症。方法选择60例维持性血液透析患者随访9个月，应用PDCA四步法，即设计（plan）-实施（do）-检验（check）-应用（act），设计并实施改善患者高磷血症的治疗流程。结果在CQI后，高磷血症患者的平均血磷水平由（2．39±0．56）mmol／L下降至（1．81±0．27）mmol／L（P〈0．01）；血磷≤1．78mmol／L的患者比例从40．O％上升至58．3％（P〈0．05）；钙磷乘积≤55的患者比例从61．7％上升至90．0％（PdO．01）。结论CQI的方法可以显著改善维持性血液透析患者的高磷血症。

Objective To improve hyperphosphatemia management in hemodialysis patients through continuous quality improvement （CQI）） process. Methods Sixty patients subject to maintenance were followed up for 9 months. By using the 4-step problem-solving framework called the PDCA cycle-plan,do,check and act,we conducted a CQI program. Results After CAI, the blood phosphoni- um was decreased from （2.39 ＋ 0. 56） to （1.81 ±0. 27） mmol/L （P〈0. 01 ） in hyperphosphatemia patients;The proportion of patients with p3＋ ≤1.78 mmol/L was increased from 40. 0% to 58. 3% （P〈 0. 05）;The proportion of patients with calcium-phosphorus product≤55 was increased from 61.7% to 90. 0 % （P〈0. 01 ）. Conclusions CQI is a useful method in the management of hyperphosphatemia in hemodialysis patients.