质量管理体系在体外循环的应用与探讨  

Evaluation and Usage of Quality Management in Cardiopulmonary Bypass

作　　者：刘炜[1] 徐建军[2] 支惠珍[1] 李淑红[1] 余发珍[1] 郑琴[1] 卢志兰[1] 肖鲁良[3] 

机构地区：[1]南昌大学第二附属医院手术室,江西南昌330006 [2]南昌大学第二附属医院心胸科,江西南昌330006 [3]南昌大学第二附属医院南昌大学护理系,江西南昌330006

出　　处：《中国体外循环杂志》2009年第3期152-155,共4页Chinese Journal of Extracorporeal Circulation

摘　　要：目的探讨在心脏手术期间体外循环(CPB)质量管理(QM)的定量评价方法。方法将可控的生理指标作为CPB目标管理的基础,分析CPB质量变化的规律,确定CPB的质量水平与围手术期恢复之间的关系。结果CPB QM控制项目成人得分偏低的项目是红细胞比积和静脉混合血氧饱和度,儿童得分偏低的项目是尿量、pH和静脉混合血氧饱和度。QM控制项目得分与住院费用、呼吸机使用时间及ICU停留时间呈负相关,R分别为:-0.445,-0.411、-0.462,P分别为0.0 0 1,0.0 4 2、0.0 1。呼吸机使用时间与ICU呈正相关,R=0.6 0 7,P=0.001。结论该体系可以用于心脏手术期间CPB QM的定量评价。OBJECTIVE To explore the methods of cardiopulmonary bypass （CPB） quality management during heart suegery. METHODS To establish a CPB database and quality management. The management foundation is based on controlled physiology parameter, and by analysis of the rule of CPB quality changes and definite relationship of between CPB quality level and peri - operative recovery. RESULTS In adults lower score items were hematocrit and venous blood saturation. In the children low score items were urine output, pH and venous blood saturation, the correlated relationship between the CPB quality. Management system score and in hospital service charge, duration of ventilator and lengh of ICU stay was R = - 0. 445, - 0.411, - 0.462 ; P = 0. 001,0.042,0.01 respectively. The correlated relationship between duration of ventilator and length of ICU stay was R = 0. 607, P = 0. 001. CONCLUSION This system could be used to evaluate CPB quality managenent during heart surgey.

关 键 词：体外循环 质量管理 心脏手术 

分 类 号：R654.2[医药卫生—外科学]