[持续质量改进（CQI）对持续性非卧床腹膜透析（CAPD）患者高血压管理的影响]

[Effect of continuous quality improvement (CQI) on hypertension management in continuous ambulatory peritoneal dialysis(CAPD) patients].

作者信息

Wang Xin, Wang Tao

机构信息

Department of Nephrology, Peking University First Hospital, Beijing 100034, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2004 Apr;36(2):190-3.

PMID:15100741

Abstract

OBJECTIVE

To improve hypertension management in peritoneal dialysis patients through CQI process.

METHODS

Using the 4-step problem-solving framework called the PDCA cycle-plan, do, check and act, we conducted a CQI program.

RESULTS

One hundred and forty-five peritoneal dialysis patients dialyzed for more than 3 months participated in the study. In 49 prevalent patients, the incidence of uncontrolled hypertension (BP>or=140/90 mm Hg 1 mm Hg=0.133 kPa) decreased from 49% to 16.3% although there were no significant changes in antihypertensive medication and total fluid removal. The incidence of uncontrolled hypertension in incident patients decreased from 61.3% to 28%. Height normalized extracellular water decreased significantly. In males it was from (10.8+/-1.4) kg/m to (10.3+/-1.7) kg/m and in females (9.6+/-1.2) kg/m to (8.6+/-1.2) kg/m.

CONCLUSION

CQI is a useful method in the management of hypertension in peritoneal dialysis patients.

摘要

目的

通过持续质量改进（CQI）流程改善腹膜透析患者的高血压管理。

方法

我们采用名为PDCA循环（计划、执行、检查和行动）的四步问题解决框架开展了一项CQI项目。

结果

145例接受腹膜透析3个月以上的患者参与了本研究。在49例现存患者中，尽管降压药物和总脱水量没有显著变化，但未控制高血压（血压≥140/90 mmHg，1 mmHg = 0.133 kPa）的发生率从49%降至16.3%。新发病例中未控制高血压的发生率从61.3%降至28%。身高标准化细胞外液显著减少。男性从（10.8±1.4）kg/m降至（10.3±1.7）kg/m，女性从（9.6±1.2）kg/m降至（8.6±1.2）kg/m。