体外膜肺氧合患者抗凝监测信息化模块的构建及应用  

Construction and application of anticoagulation monitoring informatization module for extracorporeal membrane oxygenation patients

作　　者：辛晨 盖玉彪[1] 姜文彬[2] 田惠[3] 张艳[4] 魏丽丽[5] Xin Chen;Gai Yubiao;Jiang Wenbin;Tian Hui;Zhang Yan;Wei Lili(Department of Critical Care Medicine,West Coast Branch,the Affiliated Hospital of Qingdao University,Qingdao 266500,China;Department of Nursing,the Affiliated Hospital of Qingdao University,Qingdao 266001,China;Interventional Operating Room,West Coast Branch,the Affiliated Hospital of Qingdao University,Qingdao 266500,China;Department of Nursing,Shinan Branch,the Affiliated Hospital of Qingdao University,Qingdao 266000,China;Dean's Office,the Affiliated Hospital of Qingdao University,Qingdao 266001,China)

机构地区：[1]青岛大学附属医院西海岸院区重症医学科,青岛266500 [2]青岛大学附属医院护理部,青岛266001 [3]青岛大学附属医院西海岸院区介入手术室,青岛266500 [4]青岛大学附属医院市南院区护理部,青岛266000 [5]青岛大学附属医院院长办公室,青岛266001

出　　处：《中华现代护理杂志》2025年第10期1278-1283,共6页Chinese Journal of Modern Nursing

基　　金：2023年医疗质量(循证)管理研究项目(YLZLXZ23G108);2023年度山东省医药卫生科技项目(202314050911)。

摘　　要：目的通过构建体外膜肺氧合(ECMO)患者抗凝监测信息化模块,优化ECMO患者抗凝监测信息化流程并评价其应用效果。方法成立信息化小组,在查阅文献的基础上,编制ECMO患者抗凝监测信息表,并基于数据共享架构整合现有的医院管理信息系统、实验室信息管理系统、医学影像信息系统及重症监护信息系统,构建具有数据共享、实时提醒、信息支撑功能的ECMO患者抗凝监测信息化模块,并临床应用进行效果观察。采用便利抽样法,选取2022年10月—2023年9月青岛大学附属医院ICU收治的60例ECMO患者为研究对象,将2022年10月—2023年3月收治的ECMO患者作为对照组(n=30),应用常规的ECMO抗凝监测方式;2023年4—9月收治的ECMO患者作为试验组(n=30),应用抗凝监测信息化模块进行ECMO抗凝监测。比较两组患者的抗凝监测及时率、抗凝药物调节及时率、血栓形成及出血的发生率。结果试验组ECMO患者抗凝监测及时率、抗凝药物调节及时率分别为(93.38±6.31)%、(91.90±4.71)%,均高于对照组的(83.01±9.94)%、(83.49±12.83)%,差异有统计学意义(均P<0.01)。试验组ECMO患者血栓形成发生率及出血发生率分别为16.67%(5/30)、26.67%(8/30),均低于对照组的40.00%(12/30)、53.33%(16/30),差异有统计学意义(均P<0.05)。结论基于抗凝监测信息化模块优化后的抗凝监测信息化流程具有较好的临床应用效果,能够降低ECMO患者出血和凝血的发生率。Objective To optimize the anticoagulation monitoring process for extracorporeal membrane oxygenation(ECMO)patients by constructing an informatization module and evaluate its application effect.Methods An informatization team was established,and based on literature review,an anticoagulation monitoring information sheet for ECMO patients was developed.Using a data-sharing architecture,existing hospital information management system,laboratory information management system,picture archiving and communication system,and ICU monitoring system were integrated to construct an ECMO anticoagulation monitoring informatization module with data sharing,real-time alerts,and information support functions.Clinical applications were observed for effect.A convenience sampling method was employed to select 60 ECMO patients treated in the ICU of the Affiliated Hospital of Qingdao University from October 2022 to September 2023.The patients admitted from October 2022 to March 2023 were designated as the control group(n=30),using the conventional anticoagulation monitoring method;those admitted from April to September 2023 were designated as the experimental group(n=30),using the anticoagulation monitoring informatization module.The anticoagulation monitoring timeliness rate,anticoagulant drug adjustment timeliness rate,and the incidence rates of thrombosis and bleeding were compared between the two groups.Results The timeliness rate of anticoagulation monitoring and the timeliness rate of anticoagulant drug adjustment in the experimental group were(93.38±6.31)%and(91.90±4.71)%,respectively,which were higher than those in the control group(83.01±9.94)%and(83.49±12.83)%,with statistically significant differences(both P<0.01).The incidence rates of thrombosis and bleeding in the experimental group were 16.67%(5/30)and 26.67%(8/30),respectively,which were lower than those in the control group 40.00%(12/30)and 53.33%(16/30),with statistically significant differences(both P<0.05).Conclusions The optimized anticoagulation monitoring inf

关 键 词：体外膜肺氧合 抗凝监测 信息化 流程 

分 类 号：R47[医药卫生—护理学]