戴明循环管理模式在肾小球滤过率检查中的应用效果分析  

Application effect analysis of PDCA cycle in glomerular filtration rate examination

作　　者：李文波[1] 李佳[1] 雷成明[1] 王政杰[1] LI Wenbo;LI Jia;LEI Chengming;WANG Zhengjie(Department of Nuclear Medicine,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院核医学科,重庆400016

出　　处：《现代医药卫生》2022年第11期1816-1819,1824,共5页Journal of Modern Medicine & Health

基　　金：重庆市自然科学基金项目(cstc2020jcyj-msxmX0713)。

摘　　要：目的比较戴明循环管理模式(PDCA)和常规管理模式对肾小球滤过率检查(GFR)准确性的影响。方法选取2018年1月至2019年12月该院行肾功能异常GFR检查患者1102例进行回顾性分析。以常规管理模式下实施GFR检查的311例作为对照组,以PDCA下实施GFR检查的801例作为观察组,使用鱼骨图、柏拉图、根因分析法探讨其中的主要原因,对比2组患者GFR水平及其准确性,采用独立样本秩和检验、χ^(2)检验和t检验,对操作不规范导致不准确项进行统计分析。结果同一工作人员对于图像重复处理所获得的左肾GFR水平分别为(41.200±8.130)、(40.920±7.410)mL/min,右肾GFR水平分别为(34.370±12.140)、(33.560±12.090)mL/min,差异均无统计学意义(P>0.05);不同工作人员对图像处理得到的左肾GFR水平分别为(37.930±10.240)、(38.300±9.850)mL/min,右肾GFR水平分别为(33.010±12.280)、(32.870±12.170)mL/min,差异均无统计学意义(P>0.05);采用手动勾画和自动勾画双肾显像区域,得到的左肾GFR水平分别为(44.270±6.250)、(40.730±6.080)mL/min,右肾GFR水平分别为(34.790±12.280)、(31.950±11.330)mL/min,差异均有统计学意义(P<0.05);采用手动勾画和自动勾画相同位置本底区域,得到的左肾GFR水平分别为(35.070±11.870)、(31.730±10.890)mL/min,右肾GFR水平分别为(43.650±8.550)、(39.040±8.050)mL/min,差异均有统计学意义(P<0.05);对照组GFR水平准确率为84.89%,观察组为98.50%,差异有统计学意义(P=0.027)。结论PDCA在GFR检查操作中有显著效果,能提高该检查操作的质量和准确性。Objective To compare the accuracy of plan do check action(PDCA)and routine management mode in terms of glomerular filtration rate(GFR).Methods A retrospective analysis was performed on 1102 cases of GFR examination of renal dysfunction in the department from January 2018 to December 2019.A total of 311 cases of GFR examination under conventional management mode were taken as the control group,and 801 cases of GFR examination under PDCA mode were taken as the observation group.The material causes were discussed by using fishbone diagram,pareto diagram and root cause analysis,GFR levels and accuracy were compared between the two groups.Using independent sample rank sum test,χ^(2) test and t test analyzed the inaccurate value caused by non-standard operation were statistically analyzed.Results The GFR values of left kidney and right kidney obtained by the same worker for image repeated processing were(41.200±8.130)mL/min vs.(40.920±7.410)mL/min,(34.370±12.140)mL/min vs.(33.560±12.090)mL/min,respectively,and the differences were not statistically significant(P>0.05).The GFR values of left kidney and right kidney obtained by image processing by different workers were(37.930±10.240)mL/min vs.(38.300±9.850)mL/min,(33.010±12.280)mL/min vs.(32.870±12.170)mL/min,respectively,and the differences were not statistically significant(P>0.05).The GFR values of left kidney and right kidney obtained by manual delineation and automatic delineation of double kidney imaging areas were(44.270±6.250)mL/min vs.(40.730±6.080)mL/min and(34.790±12.280)mL/min vs.(31.950±11.330)mL/min,respectively,and the differences were statistically significant(P<0.05).The GFR values of left kidney and right kidney by manually sketching and automatically sketching the same background region were(35.070±11.870)mL/min vs.(31.730±10.890)mL/min and(43.650±8.550)mL/min vs.(39.040±8.050)mL/min,respectively,and the differences were statistically significant(P<0.05).The accuracy of GFR value in the observation group was 98.50%,compared with 84.89

关 键 词：戴明循环管理模式 肾小球滤过率 质量管理 效果分析 

分 类 号：R445.5[医药卫生—影像医学与核医学]