——任婷婷 朱小宇 高露露 王线妮

【摘要】视神经脊髓炎谱系疾病致残率高，复发率高，严重威胁患者生活质量。针对视神经脊髓炎谱系疾病患者生活质量低的现状展开原因分析，从完善制度、构建多学科协作团队、健康宣教、持续干预4方面予以规范化治疗及护理，使视神经脊髓炎谱系疾病患者生活质量提高率从49.60%提高至89.74%，有效降低了疾病复发率及致残率，减轻了家庭经济负担。

【关键词】 品管圈；问题解决型品管圈；视神经脊髓炎谱系疾病；生活质量；多学科协作

中图分类号：R197.323;R744.5+2文献标识码：B

Improving the Quality of Life of Patients with Neur Myelitis Optica Spectrum Disorders/REN Tingting,ZHU Xiaoyu,GAO Lulu,et al.//Chinese Health Quality Management，2021,28(11):78-82

Abstract Neur Myelitis Optica Spectrum Disorders (NMOSD) have a high rate of disability and recurrence, which seriously threaten the quality of life of patients. The causes of the low quality of life of NMOSD patients were analyzed, and the standardized treatment and nursing was made from four aspects of system improvement, construction of multidisciplinary team, health education and continuous intervention, so that the improvement rate of quality of life of patients with NMOSD was increased from 49.60% to 89.74%, effectively reduce the patient disability rate, recurrence rate, and reduce the family economic burden.

Key words Quality Control Circle; Problem Solving Quality Control Circle; Neur Myelitis Optica Spectrum Disorders; Quality of Life; Multidisciplinary Collaboration

First-author's address?/b>The Second Affiliated Hospital of Air Force Medical University, Xi'an,Shaanxi,710038,China

1主题选定

全体圈员从上级政策、重要性、迫切性、圈能力4个维度，采用“5-3-1”打分法，对4个备选主题进行评价，按照得分顺位，选定“提高视神经脊髓炎谱系疾病患者生活质量”作为本期活动主题。

名词定义：（1）视神经脊髓炎谱系疾病（Neur Myelitis Optica Spectrum Disorders，NMOSD）是一种免疫介导的以视神经和脊髓受累为主的中枢神经系统炎性脱髓鞘疾病［1］。（2）生活质量即使用SF-36量表从躯体活动功能、躯体角色功能、疼痛、活力、总体健康、社会功能、情绪角色功能、心理健康等8个领域进行评估，为患者康复效果评价指标之一［2］。

衡量指标：NMOSD患者生活质量提高率=NMOSD患者生活质量提高例数÷总NMOSD患者例数×100%。

选题背景：对国际NMOSD诊断标准［3］及中国视神经脊髓炎谱系疾病诊断与治疗指南［4］进行分析发现，NMOSD病变累及部位不仅包括视神经、脊髓，还包括脑实质。约50%的患者出现严重行走困难，60%～70%的患者失明或一侧视力受影响，多数患者遗留伴发症状如尿便障碍、皮肤瘙痒、疼痛、睡眠障碍等［5-7］；约60%的患者在1 a内复发，90%的患者在3 a内复发，发病人群以青壮年居多，女性适孕年龄高发［3］，致残率高，复发率高［2］，严图2患者依从性差的原因图3患者复发率高的原因图4患者康复锻炼不规范的原因重影响患者生活质量。

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