基于5E模式下持续质量改进对腹膜透析患者透析充分性及导管存活率的影响  

The Influence of 5E-based Continuous Quality Improvement on the Dialysis Adequacy and Catheter Indwelling Rates for Peritoneal Dialysis Patients

作　　者：许慧慧[1] 冯晓然[1] 李刚[1] 程妩铭 黄晓羽 张丰萍 XU Hui-hui;FENG Xiao-ran;LI Gang;CHENG Wu-ming;HUANG Xiao-yu;ZHANG Feng-ping(Department of Nephrology,Jiujiang No.1 People’s Hospital,Jiujiang 332000,Jiangxi Province,China)

机构地区：[1]九江市第一人民医院肾内科,江西九江332000

出　　处：《罕少疾病杂志》2025年第4期111-114,共4页Journal of Rare and Uncommon Diseases

基　　金：江西省卫生健康委科研项目(20187133);江西省卫生健康委科研项目计划(20204203)。

摘　　要：目的研究基于5E模式持续质量改进(CQI)对腹膜透析患者透析充分性及导管存活率的影响。方法临床研究对象选择2020年1月至2022年1月在本院进行诊治的腹膜透析患者96例,采取随机数字排列表法将其分为观察组和对照组,每组各48例。对照组患者进行CQI护理干预,观察组则使用基于5E模式下的CQI进行护理干预,观察两组患者血压、体质量、尿量、钙磷代谢紊乱发生情况、透析充分性、临床指标、导管存活率及诊治效率,并进行对比。结果干预前两组患者血压、体质量及尿量基本相同(P>0.05),干预后观察组血压及体质量相对于对照组更低,且观察组患者尿量高于对照组(P<0.05);观察组患者甲状旁腺功能亢进、高磷血症、高钙血症、低钙血症及血管钙化发生率相对于对照组更低(P<0.05);干预前两组透析充分性指标水平基本相同(P>0.05),干预后观察组患者腹膜Kt/V、腹膜Ccr、总Kt/V及总Cc指标水平相对于对照组更高(P<0.05);干预后观察组患者住院天数、留置时间相对于对照组更低,且观察组导管存活率(47.92%)相对于对照组(22.92%)更高(P<0.05);观察组诊治总有效率(95.83%)相对于对照组(81.25%)更高(P<0.05)。结论针对腹膜透析患者使用基于5E模式下持续质量改进一方面有利于改善患者血压、体质量及尿量指标、降低钙磷代谢紊乱发生率、改善透析充分性;另一方面有利于改善临床指标、提高导管存活率及诊治效率,具有临床应用价值,值得推广运用。Objective To explore the clinical effects of 5E-based continuous quality improvement(CQI)on the dialysis adequacy and catheter indwelling rates for peritoneal dialysis patients.Methods 96 patients of undergoing the peritoneal dialysis from January 2020 to January 2022 were chosen as research subjects.According to the random permutation method,patients were divided into observation group(n=48)and control group(n=48).The control group was served with CQI;the observation group was served with 5E-based CQI.The group contrast results were reviewed through the blood pressure,body mass index,urine volume,calcium-phosphorus metabolism disorder rates,dialysis adequacy,clinical indicators,catheter indwelling rates and treatment rates.Results Before interventions,the blood pressure,body mass index and urine volume between groups were not significantly different(P>0.05);after interventions,the blood pressure and body mass index in the observation group were lower than control group;the urine volume in the observation group was larger than control group(P<0.05);the incidences of hyperparathyroidism,hyperphosphatemia,hypercalcemia,hypocalcemia and angiosteosis in the observation group were significantly lower than control group(P<0.05);before interventions,the dialysis adequacy indexes between groups were not significantly different(P>0.05);after interventions,Kt/V,creatinine clearance rate(Ccr),total Kt/V and Cc values in the observation group were significantly higher than control group(P<0.05);after interventions,the hospitalization days and catheter indwelling time in the observation group were shorter than control group;the catheter indwelling rates in the observation group(47.92%)were significantly higher than control group(22.92%)(P<0.05);the total treatment rates in the observation group(95.83%)were significantly higher than control group(81.25%)(P<0.05).Conclusion 5E-based continuous quality improvement can effectively reduce the blood pressure,body mass index and calcium-phosphorus metabolism disorder,and improve the

关 键 词：5E模式 持续质量改进 腹膜透析 透析充分性 导管存活率 

分 类 号：R459.5[医药卫生—治疗学]