2022年度厦门市肾病专业质量控制数据分析
发布人：yaot 发布时间：2023/8/15 9:16:01 浏览次数：605次
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】——陈智鸿 王莉 林丽瑜 李彩凤 林雪萍 谢起雯 林琳 邱珊芳 滕杰
【摘要】目的 调查厦门市肾病专业质控数据，了解该市肾病学科发展规模及诊疗现状，为患者提供更加安全、可靠、高质量的医疗服务。方法 厦门市肾病专业质量控制中心对13家医院2022年度专业质控数据进行采集、整理和描述性分析。结果 共有肾脏专科医生156名，护士397名，透析工程师17名，肾病专科床位393张，透析相关设备623台。肾脏病专科门诊共接诊134 283例患者，年度住院患者8 154例；年度内手术操作累计3 457例次；住院患者中，分别有4.39%慢性肾脏病患者和46.56%急性肾损伤患者未接受分期评估。前3位的肾小球疾病分别为糖尿病肾病（1 154例）、IgA肾病（881例）和膜性肾病（740例）。糖尿病肾病患者糖化血红蛋白达标率为46.50%，低密度脂蛋白胆固醇达标率为53.62%；接受肾穿刺的IgA肾病随访患者中，血压和尿蛋白达标率分别为81.74%、62.60%，但有2.10％的患者出现肾功能恶化。结论 厦门市肾病专业质控工作仍处于初级阶段，今后需重点加强肾病专科护士队伍建设，完善质控信息采集，规范肾功能分期诊断，提高重点病种管理水平。
【关键词】厦门市；肾脏病专科；质量控制；质控中心
中图分类号：R197.323；R692 文献标识码：A
Analysis of Quality Control Data of Nephrology in Xiamen in 2022/CHEN Zhihong,WANG Li,LIN Liyu,et al.//Chinese Health Quality Management，2023,30(7):18-23
Abstract Objective To investigate the professional quality control data of nephrology in Xiamen, explore the development scale and diagnosis and treatment status of nephrology, and provide more safe, reliable and high-quality medical services for patients.Methods The 2022 quality control data of 13 hospitals were collected, sorted and analyzed by Xiamen Nephrology Quality Control Center.Results There were 156 physicians of nephrology, 397 nurses, 17 dialysis engineers, 393 beds of nephrology and 623 dialysis-related equipment in the city. A total of 134 283 patients were treated in the specialized outpatient department of kidney disease, including 8 154 inpatients annually. A total of 3 457 surgical operations were performed annually. Among hospitalized patients, 4.39% of patients with chronic kidney disease and 46.56% of patients with acute kidney injury did not receive staging assessment, respectively. The top 3 glomerular diseases were diabetic nephropathy (1 154 cases), IgA nephropathy (881 cases) and membranous nephropathy (740 cases). 46.50% of diabetic nephropathy patients met the standard of glycosylated hemoglobin and 53.62% of low-density lipoprotein. In IgA nephropathy patients receiving renal puncture, 81.74% and 62.60% of blood pressure and urine protein reached the standard, respectively, but 2.10% of patients showed deterioration of renal function.Conclusion The quality control of Nephrology in Xiamen is still at an early stage. In the future, emphasis should be placed on strengthening the construction of the nephrology specialized nursing team, improving the collection of quality control information, standardizing the staging diagnosis of kidney function, and improving the management level of key diseases.
Key words Xiamen;Department of Nephrology;Quality Control;Quality Control Center
Firstauthor's address Xiamen Branch,Zhongshan Hospital,Fudan University,Xiamen,Fujian,361015,China
慢性肾脏病(Chronic Kidney Disease, CKD) 是危害人类健康的重大公共卫生问题，全球患病率约为8%~16%，并呈逐年增长趋势［1］。我国CKD患者已经超过1.3亿人［2］。国内外肾脏病领域专家长期致力于CKD的诊疗与管理。2019年，改善全球肾脏病预后组织(Kidney Disease: Improving Global Outcomes, KDIGO)召开了“CKD早期识别和干预”的专题研讨会，明确了CKD的早期筛查、风险分层和治疗策略［3］。上海市肾内科临床质量控制中心专家组于2022年颁布了新版《慢性肾脏病早期筛查、诊断及防治指南》为CKD管理提供了临床参考［4］。
医疗质量是医疗安全的重要保障，也是推进医疗卫生事业高质量发展的核心。2021年，国家卫生健康委首次印发《国家医疗质量安全改进目标》［5］，体现了国家层面对医疗质量安全的高度重视。2020年1月，复旦大学附属中山医院厦门医院成为“厦门市肾病专业质量控制中心”(以下简称“肾病质控中心”)挂靠单位。同年，肾病质控中心启动了厦门市肾病专业质控工作，并持续优化医疗质量评价指标。2022年，肾病质控中心专家委员会在既往工作基础上，结合国家医疗质量管理与控制信息网(National Clinical Improvement System, NCIS)相关医疗数据采集要求，制定《2022年度肾病专业质控统计调查表》，开展了2022年度全市肾病质控工作。本研究通过分析2022年度质控数据，旨在了解厦门市肾脏病专科发展现状，为今后质控工作提供指导，为患者提供更加安全、可靠、高质量的医疗服务。
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