基于武汉市血液透析质量控制平台的数据反馈提升血磷达标率的研究

A study on improving the compliance rate of plasma phosphorus based on data feedback from Wuhan Hemodialysis Quality Control Platform

目的基于武汉市血液透析质量控制平台,利用其数据反馈结果,以提升武汉地区整体血磷(phosphorus,P)达标率。方法选取2018年1月~2019年1月武汉市44家血液透析中心共3794名血液透析患者为研究对象,利用武汉市血液透析质量控制平台的数据反馈,统计其P的检查和达标情况,经反复评估、整改,对比1年后P检查和达标情况。结果①患者P、甲状旁腺激素(parathyroid hormone,PTH)水平呈降低趋势(F=11.976、10.414,P<0.001、0.015),血钙(calcium,Ca)水平呈升高趋势(χ^2=119.725,P<0.001)。②患者P、Ca、PTH的检查率不断完善,均呈上升趋势(χ^2=65.994、80.834、182.306,均P<0.001)。③患者P、Ca的达标率呈上升趋势(χ^2=32.511、10.215,P<0.001、0.017),血PTH达标率无明显变化(χ^2=0.764,P=0.858)。结论基于平台的数据反馈,进行持续质量改进,能有效降低P水平,提高P的检查率和达标率。

Objective To improve the overall serum phosphorus(P)compliance rate in Wuhan based on the data feedback from Wuhan Hemodialysis Quality Control Center platform.Methods A total of 3,794 hemodialysis patients from 44 hemodialysis centers in Wuhan in the period from January 2018 to January2019 were selected as the research subjects.The data feedback from Wuhan Hemodialysis Quality Control Center platform were used to calculate the serum P examination and compliance rates.After repeated evaluations and renovations for one year,serum P examination and compliance rates were rEcalculated and compared with the previous rates.Results①Serum P and parathyroid hormone(PTH)levels decreased(F=11.976 and 10.414 respectively;P<0.001 and=0.015 respectively),and serum calcium(Ca)increased(χ^2=119.725,P<0.001).②The rates of serum P,Ca and PTH examinations improved and increased constantly(χ^2=65.994,80.834 and 182.306 respectively,P<0.001).③The compliance rates of serum P and Ca increased(χ^2=32.511 and 10.215 respectively,P<0.001 and=0.017 respectively),but the compliance rate of PTH remained unchanged(χ^2=0.764,P=0.858).Conclusion Based on the data feedback from this platform and continuous quality improvement,serum P level effectively reduced and serum P examination and compliance rates increased.