血液透析信息化管理系統在透析充分性管理的應用

Experience of Hemodialysis Information Management System Construction

目的探討血液透析信息化管理系統(Hemodialysis information management system,HIMS)對改善透析充分性的影響。方法通過HIMS採集2016年7月~2017年3月期間常規血液透析(Hemodialysis,HD)患者的機測Kt/V和基於血清BUN值計算的SpKt/V值,比較二者之間的差異性。同時分析SpKt/V不達標者的原因並進行相應透析處方調整,觀察透析充分性改善情況。結果機測Kt/V與SpKt/V值之間比較存在顯著差異(P<0.05)。使用HIMS對透析充分性進行監測和管理後,患者SpKt/V達標率上升,不達標率下降,使用前後對比有統計學差異(P<0.05)。結論HIMS有助改善患者的透析充分性,提高透析品質。

Objective To investigate the change of hemodialysis adequacy after the implementation of hemodialysis information management system(HIMS).Methods Data of the patients who underwentregular hemodialysis(HD)from July 2016 to March 2017 were collected through HIMS.On-line measurement of Kt/V and estimated SpKt/V based on serum BUN were compared.Those patients who could not reach Kt/V target were further analyzed for the causes,and HD prescriptions were modified.The thereafter changes of HD adequacy were observed.Results There was a significant difference between the estimated SpKt/V and on-line measurement Kt/V.After the implementation of HIMS,SpKT/V target-reaching rate got significantly improved and non-compliance rate declined(P<0.05).Conclusion HIMS could assist to achieve better HD adequacy and improve the HD quality of the patients.