基于Kaiser模型的灾害脆弱性分析在CT-Sim定位中的应用  

Application of Hazard Vulnerability Analysis Based on Kaiser Model in CT-Sim Localization

作　　者：何勇[1] 李林涛[1] 梁旭[2] 王宇 He Yong;Li Lintao;Liang Xu;Wang Yu(Radiotherapy Center,,Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,Affiliated Cancer Hospital of University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China;Department of Radiology,Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,Affiliated Cancer Hospital of University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China)

机构地区：[1]四川省肿瘤临床医学研究中心,四川省肿瘤医院·研究所,四川省癌症防治中心,电子科技大学附属肿瘤医院放疗中心,成都610041 [2]四川省肿瘤临床医学研究中心,四川省肿瘤医院·研究所,四川省癌症防治中心,电子科技大学附属肿瘤医院影像科,成都610041

出　　处：《肿瘤预防与治疗》2024年第9期781-786,共6页Journal of Cancer Control And Treatment

基　　金：成都市科技局技术创新研发项目(编号:2022-YF05-01812-SN)。

摘　　要：目的:通过灾害脆弱性分析,明确计算机断层扫描模拟(computed tomography simulation,CT-Sim)定位环节患者安全风险因素,梳理需要重点关注的因素及防控应对措施。方法:邀请国内各大放疗中心共21位从事CT-Sim的专家们进行调查研究,使用Kaiser模型,首先经专家组头脑风暴梳理出CT-Sim定位环节可能发生的患者安全风险因素,将因素输入Kaiser模型,从风险因素发生的可能性和危害性两个部分评估,以发生的可能性为权重,结合严重性得分进行统计学处理,计算各风险因素的相对风险系数。结果:CT-Sim定位环节中排名前5的患者安全风险因素分别为:骨转移患者的骨折(风险系数为47.18%)、儿童患者不配合导致的扫描失败(风险系数为43.56%)、患者呼吸不规律导致图像误差(风险系数为43.47%)、高危患者窒息(风险系数为39.15%)、增强扫描时患者出现过敏反应导致呕吐产生的窒息(风险系数为37.13%)。结论:应用灾害脆弱性分析评估CT-Sim定位工作环节风险因素,有利于CT-Sim定位工作者们认识重点风险因素,开展应对演练,提高医疗安全。Objective:Hazard vulnerability analysis was used to identify the patient’s safety risk factors in computed tomography simulation(CT-SIM)localization,and to identify the key factors and preventive measures.Methods:A total of 21 experts in CT-Sim from radiotherapy centers in China were invited to conduct an investigation and study.Using Kaiser model,the safety risk factors of patients during CT-Sim were identified by brainstorming among the experts.Factors were entered into the Kaiser model and assessed from both the probability and the harmfulness of the risk factors.With the probability of occurrence weighted and the severity score statistically processed,calculate the relative risk coefficient of each risk factor.Results:The top 5 safety risk factors during CT-Sim were fracture risk coefficient of bone metastasis patients(47.18%),scan failure risk coefficient of non-cooperation of children patients(43.56%),image error risk coefficient of irregular breathing of patients(43.47%),asphyxia risk coefficient of high-risk patients(39.15%),and asphyxia risk coefficient of anaphylaxis of patients during enhanced scan(37.13%).Conclusion:The application of hazard vulnerability analysis to evaluate the risk factors of CT-Sim is helpful for CT-Sim localization workers to understand the key risk factors,carry out coping exercises and improve medical safety.

关 键 词：CT模拟定位 灾害脆弱性分析 风险事件 患者安全 

分 类 号：R730.55[医药卫生—肿瘤]