连续性肾脏替代治疗质量控制指标体系的建立及验证  

Establishment and validation of quality control index system for continuous renal replacement therapy

作　　者：邱英鹏 李欣雨 邱海波[3] 刘松桥[3] 张凌[4] 于湘友[5] 秦秉玉[6] 蒲莹莹 赵佳钰 刘永军[2] 肖月 杨毅[3] Qiu Yingpeng;Li Xinyu;Qiu Haibo;Liu Songqiao;Zhang Ling;Yu Xiangyou;Qin Bingyu;Pu Yingying;Zhao Jiayu;Liu Yongjun;Xiao Yue;Yang Yi(China National Health Development Research Center,National Health Commission,National Center for Medicine and Health Technology Assessment,Beijing 100000,China;School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing 210000,China; Department of Critical Care Medicine,Zhongda Hospital,School of Medicine,Southeast University,Nanjing 210009,China;Department of Nephrology,West China Hospital of Sichuan University,Chengdu 610000,China;Critical Medicine Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;Department of Intensive Care Medicine,Henan Provincial People’s Hospital,Zhengzhou 450000,China;Chaoyang District Health Supervision Institute,Beijing 100000,China)

机构地区：[1]国家卫生健康委卫生发展研究中心暨国家药品与卫生技术综合评估中心,北京100000 [2]中国药科大学国际医药商学院,南京210000 [3]江苏省重症医学重点实验室,东南大学附属中大医院重症医学科,南京210009 [4]四川大学华西医院肾脏内科,成都610000 [5]新疆医科大学第一附属医院重症医学中心,乌鲁木齐830000 [6]河南省人民医院重症医学科,郑州450000 [7]北京市朝阳区卫生健康监督所,北京100000

出　　处：《中华重症医学电子杂志》2024年第4期351-357,共7页Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)

基　　金：国家卫生健康委卫生发展研究中心科研课题(CNHDRC-KJ-L-2020-30)

摘　　要：目的建立连续性肾脏替代治疗(CRRT)质量控制指标体系,通过收集真实世界数据对影响结局指标的关键因素进行探究。方法以三维质量评价模型为理论框架,采用文献分析、专家咨询法构建质量控制指标体系;收集4个省6家医院ICU中接受CRRT的患者信息以及6家医疗机构信息,采用回顾性队列研究,探讨影响结局指标的因素。结果共进行2轮专家咨询,最终形成包括2个一级指标、6个二级指标、26个三级指标的CRRT质量控制指标体系;多因素回归分析结果显示,上机指征、疾病诊断类型等是影响结局指标的关键因素。结论本研究构建的CRRT质量控制指标体系具有一定的科学性和合理性,可为CRRT临床质量控制提供参考,实践中应重视影响结局指标的关键环节,不断完善CRRT临床质量控制指标体系。Objective To establish a quality control index system for continuous renal replacement therapy(CRRT),and explore key factors that affect outcome indicators by collecting real-world data.Methods A three-dimensional quality evaluation model as the theoretical framework was used,a quality control index system was constructed using literature analysis and expert consultation methods;information on patients receiving CRRT treatment from 6 hospitals in 4 provinces and 6 medical institutions were collected,and a retrospective cohort study was used to explore factors affecting outcome indicators.Results A total of 2 rounds of expert consultation were conducted,ultimately forming a CRRT quality control indicator system consisting of 2 first level indicators,6 second level indicators,and 26 third level indicators;the results of multiple factor regression analysis showed that the indications for machine use and the type of disease diagnosis were key factors affecting the outcome indicators.Conclusion The CRRT quality control indicator system constructed in this study has a certain degree of scientificity and rationality,providing reference for clinical quality control of CRRT.In practice,key links that affect outcome indicators should be emphasized,and the CRRT clinical quality control indicator system should be continuously improved.

关 键 词：连续性肾脏替代治疗 质量控制 指标体系 

分 类 号：R692[医药卫生—泌尿科学] R459.5[医药卫生—外科学]