FOCUS-PDCA对肝动脉灌注化疗药物精准输注的改善作用

Effects of FOCUS-PDCA on the improvement of precise infusion of hepatic arterial infusion chemotherapy

目的探讨焦点管理循环(find-organize-clarity-understand-select-plan-do-check-act,FOCUS-PDCA)对肝动脉灌注化疗(hepatic arterial infusion chemotherapy,HAIC)药物精准输注的改善作用。方法选取2021年7月至2022年6月浙江省肿瘤医院介入治疗科经股动脉行HAIC的原发性或转移性肝癌患者98例作为研究对象,将2021年7月至2021年12月行HAIC的患者设为对照组(n=49),将2022年1月至2022年6月行HAIC的患者设为观察组(n=49)。对照组给予常规管理,观察组给予FOCUS-PDCA,比较两组患者5-氟尿嘧啶注药泵输注时间准确率、动脉穿刺处出血率、动脉导管堵管率、用药未完成率、动脉导管体外固定方式标准率等安全性指标和患者健康教育掌握率。结果观察组的5-氟尿嘧啶注药泵输注时间准确率、动脉导管体外固定方式标准率、健康教育掌握率均显著高于对照组(P<0.05),动脉导管堵管率显著低于对照组(P<0.05)。两组动脉穿刺处出血率和用药未完成率比较,差异无统计学意义(P>0.05)。结论FOCUS-PDCA对HAIC药物精准输注具有显著改善作用,值得临床普及应用。

Objective To explore the improvement effect of find-organize-clarity-understand-select-plan-do-check-act(FOCUS-PDCA)management on precise infusion of drugs in hepatic arterial infusion chemotherapy(HAIC).Methods Ninety-eight patients with primary or metastatic liver cancer who received HAIC via femoral artery in the interventional therapy department of Zhejiang Cancer Hospital from July 2021 to June 2022 were selected as the study objects.Patients who had HAIC from July 2021 to December 2021 were taken as the control group(n=49),patients who had HAIC from January 2022 to June 2022 were taken as the observation group(n=49).The control group was given conventional management and the observation group was given FOCUS-PDCA management.The accuracy rate of 5-fluorouracil injection pump infusion time,bleeding rate at arterial puncture,occlusion rate of arterial catheter,rate of drug failure,standard rate of external fixation of ductus arteriosus and other safety indexes and the mastery rate of patients’health education were compared between the two groups.Results The accuracy of infusion time,standard rate of external femoral catheter fixation of ductus arteriosus,the mastery rate of health education in observation group were higher than those in control group(P<0.05),and the occlusion rate of the observation group was lower than that of the control group(P<0.05).There was no statistically significant difference in the bleeding rate at arterial puncture and the rate of drug failure between the two groups(P>0.05).Conclusion FOCUS-PDCA management can significantly improve the precise infusion of hepatic arterial infusion chemotherapy drugs,and it is worthy of universal clinical application.