失效模式与效应分析在中毒性表皮坏死松解症患者血浆置换中的应用效果  

Application effect of failure mode and effects analysis in plasma exchange of patients with toxic epidermal necrolysis

作　　者：甘金华 门华琳 雷昊[1] 廖天治 石龙 胡超娅[1] Gan Jinhua;Men Hualin;Lei Hao;Liao Tianzhi;Shi Long;Hu Chaoya(Department of Critical Care Medicine,Chengdu Second People's Hospital,Chengdu,Sichuan 610000,China;School of Medicine,Shangqiu Institute of,Shangqiu,Henan 476000,China;Emergency and Critical Care Medicine Center,The Third Affiliated Hospital of Chongqing Medical University,Chongqing 401120,China)

机构地区：[1]成都市第二人民医院重症医学科,四川成都610000 [2]商丘工学院医学院,河南商丘476000 [3]重庆医科大学附属第三医院急诊与重症医学中心,重庆401120

出　　处：《现代临床医学》2025年第1期23-25,29,共4页Journal of Modern Clinical Medicine

摘　　要：目的:探讨失效模式与效应分析(FMEA)在中毒性表皮坏死松解症(TEN)患者血浆置换中的应用效果。方法:选取2022年3月至2023年9月在成都市第二人民医院ICU住院的13例TEN患者为研究对象,在血浆置换基础上行FMEA干预,比较干预前后患者临床疗效、皮损情况、心脏及肝肾功能。结果:所有患者均按计划完成FMEA干预下的血浆置换,无非计划性下机发生,病情好转,ICU住院时间为(13.08±1.98)d,皮损好转时间为(7.69±1.65)d。FMEA干预后,患者血浆置换激素用量低于干预前(P<0.05),心脏、肝肾功能指标均较干预前改善(P<0.05),且干预7 d后较干预3 d后改善更明显(P<0.05)。结论:FMEA可提高血浆置换疗效及稳定性,及时控制TEN患者病情进展,降低病死率和激素用量。Objective:To explore the application effect of failure mode and effects analysis(FMEA)in plasma exchange of patients with toxic epidermal necrolysis(TEN).Methods:Thirteen TEN patients hospitalized in the ICU of Chengdu Second People's Hospital from March 2022 to September 2023 were selected as the research objects.FMEA intervention was carried out on the basis of plasma exchange.The clinical efficacy,skin lesion condition,cardiac function and liver and kidney function of patients before and after intervention were compared.Results:All patients completed the plasma exchange under FMEA intervention as planned,without unplanned disconnection.Their conditions improved.The length of stay in the ICU was(13.08±1.98)d,and the time for skin lesion improvement was(7.69±1.65)d.After FMEA intervention,the hormone dosage in plasma exchange of patients was lower than that before intervention(P<0.05).The cardiac,liver and kidney function indexes were all improved compared with those before intervention(P<0.05),and the improvement was more obvious 7 days after intervention than that 3 days after intervention(P<0.05).Conclusion:FMEA can improve the efficacy and stability of plasma exchange,timely control the disease progression of TEN patients,and reduce the case fatality and hormone dosage.

关 键 词：失效模式与效应分析 中毒性表皮坏死松解症 血浆置换 

分 类 号：R322.99[医药卫生—人体解剖和组织胚胎学]