“以患者为中心”整合诊疗模式在血液透析血管通路临床实践中的应用

Establishment of integrative medicine with patient first model in the clinical practice of hemodialysis access

血管通路是血液透析患者的生命线。本文从血液透析患者的特点出发,结合国内外临床实践情况和创新理论,提出在血管通路临床实践中建立"以患者为中心"整合诊疗模式。该模式将血管通路规划融入肾脏替代治疗全流程,将病变局部与通路整体、患者整体状况相结合,同时兼顾患者社会心理特征,为患者提供最合适的通路规划。该模式的实施要求组建多学科协作的血管通路团队,设置与本中心工作相适应的工作岗位并制订和优化工作流程。

Vascular accesses are the lifelines for hemodialysis patients.This paper proposes to establish an integrative medicine with patient first model in the clinical practice of vascular access based on characters of hemodialysis patients and combined with the domestic and global innovation of management of vascular access.This model emphasizes the integration of vascular access plan with the whole life plan of renal replacement therapy,the combination of characters of vessel and entire condition of the patient,as well as balanced with patient's psychosocial characters.To implement this model in clinical practice,a multidisciplinary team with different professional background should be built,suitable job position should be set up and workflows should be formulated and optimized.