DRGs背景下肝癌经皮射频消融护理质量评价指标体系的构建及应用实践  

Construction and application of nursing quality evaluation index system for percutaneous radiofrequency ablation of liver cancer under the background of disease diagnosis related groups

作　　者：黄旭芳[1] 吴巧红 毛剑婷[1] 饶巧莹 宋佳 李璟[1] 夏伟芬 HUANG Xufang;WU Qiaohong;MAO Jianting;RAO Qiaoying;SONG Jia;LI Jing;XIA Weifen(Affiliated Fifth Hospital of Wenzhou Medical University(Lishui Municipal Central Hospital),Zhejiang Provincial Key Laboratory of Imaging Diagnosis and Interventional Minimally Invasive Research,Lishui,Zhejiang Province 321000,China)

机构地区：[1]温州医科大学附属第五医院(丽水市中心医院)浙江省影像诊断与介入微创研究重点实验室,浙江丽水321000

出　　处：《介入放射学杂志》2025年第2期192-196,共5页Journal of Interventional Radiology

基　　金：浙江省医药卫生科技计划项目(2021KY1239);浙江省医药卫生科技计划项目(2024KY1859)。

摘　　要：目的基于公立医院疾病诊断相关分组(DRGs)背景构建肝癌经皮射频消融(PRFA)护理质量评价指标体系,以提高肝癌射频消融护理质量。方法运用三维质量模型,通过访谈、文献资料分析、2轮德尔菲专家函询及层次分析法,确立肝癌PRFA护理质量评价标准,并在临床验证其效果。结果研究构建了包含3个一级指标、9个二级指标、22个三级指标的肝癌PRFA护理质量评价指标体系。临床应用后干预组术中与术后中重度疼痛发生率、高热发生率、24 h日常生活需他人照护数低于对照组(P<0.05),术后Ⅲ度及以上呕吐发生率明显低于对照组(P<0.01),患者平均住院日低于对照组(P<0.05),平均住院费用低于对照组,差异无统计学意义(P>0.05)。结论研究构建的肝癌PRFA护理质量评价指标体系有较好的科学性和实用性,有利于改善患者结局,促进护理质量提升。Objective Based on the background of disease diagnosis related groups(DRGs)in public hospitals to construct the nursing quality evaluation index system for percutaneous radiofrequency ablation(PRFA)of liver cancer so as to improve the nursing quality for PRFA of liver cancer.Methods Using three-dimensional quality model and through interview,literature analysis,two rounds of Delphi expert letter inquiry and analytic hierarchy process,the evaluation standard of PRFA nursing quality of liver cancer was established,and its effect was validated in clinical practice.Results The evaluation index system of PRFA nursing quality for liver cancer was constructed,which included 3 first-level indexes,9 second-level indexes and 22 third-level indexes.After clinical application,the incidence of intraoperative and postoperative moderate-severe pain,the incidence of high fever,and the 24-hour number of times required care in the intervention group were lower than those in the control group(P<0.05),the incidence of postoperative≥Ⅲdegree vomiting in the intervention group was remarkably lower than that in the control group(P<0.01),and the average hospitalization days in the intervention group were less than those in the control group(P<0.05),and the average hospitalization expense in the intervention group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion The PRFA nursing quality evaluation index system for liver cancer is scientific and practical,which is helpful for improving the outcome of patients and promoting the quality of nursing.

关 键 词：肝癌 射频消融 护理质量 评价指标 DRGS 

分 类 号：R735.7[医药卫生—肿瘤]