| 李 佳,朱 宇,高 佳.肿瘤患者临床生化检验危急值的分析与持续改进[J].中国肿瘤,2019,28(12):951-957. |
| 肿瘤患者临床生化检验危急值的分析与持续改进 |
| Analysis and Continuous Improvement of Clinical Biochemical Critical Values in Cancer Patients |
| 中文关键词 修订日期：2019-07-04 |
| DOI：10.11735/j.issn.1004-0242.2019.12.A012 |
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| 中文关键词: 肿瘤 危急值 生化检验 |
| 英文关键词:cancer critical value clinical biochemistry |
| 基金项目:中国医学科学院肿瘤医院管理研究课题(LC2017D03) |
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| 中文摘要: |
| 摘 要：［目的］ 分析肿瘤专科医院生化项目危急值优化前后的分布与报告情况，探讨其在危急值管理持续改进中的作用。［方法］ 收集中国医学科学院肿瘤医院检验科危急值调整前（2016年7月1日至2017年6月30日）与危急值调整后（2017年7月17日至2018年7月16日）生化组所有常规化学项目的危急值数据，通过Excel2016软件和SPSS16.0统计学处理软件对数据进行统计分析。［结果］ 危急值调整前1229条生化危急值数据中，危急值项目数量排名前5位的分别为钠、氯、血糖、钾和无机磷，危急值发生数较多的科室主要有重症监护室、综合科、神经外科、胰胃外科和急诊室，部分科室危急值分布有其各自的特点；危急值调整后的945条生化危急值数据中，危急值项目数量较多的为钠、血糖、钾和钙，危急值发生数较多的科室主要有重症监护室、急诊室、综合科、胰胃外科和胸外科。危急值调整后住院患者发生危急值的比例(59.89%)较危急值调整前(75.10%)明显下降。危急值调整后门诊患者危急值的实验室内周转时间中位数较危急值调整前明显降低(P=0.000)。［结论］ 定期对危急值数据进行分析评估，能为持续改进危急值管理工作提供参考。 |
| 英文摘要: |
| Abstract：［Purpose］ To understand the distribution of clinical biochemical critical values before and after optimization in cancer hospitals，and to explore its role in the continuous improvement of critical values management. ［Methods］ All routine clinical biochemical critical values before adjustment(between July 1，2016 and June 30，2017) and after adjustment(between July 17，2017 and July 16，2018) were collected from the Department of Clinical Laboratory of Cancer Hospital，Chinese Academy of Medical Sciences. Excel2016 Software and SPSS16.0 Statistical Software were used to analyze these values. ［Results］ Among the 1229 clinical biochemical critical values before adjustment，the top five critical value items were sodium，chlorine，glucose，potassium，and phosphorus，respectively. Intensive Care Unit，Integrated Department，Department of Neurosurgery，Department of Pancreatic and Gastric Surgery.and Emergency Room were the top five departments where critical values were most frequently found. The distributions of critical values differed by departments. Among the 945 clinical biochemical critical values after adjustment，sodium，glucose，potassium，and calcium topped the list. Intensive Care Unit，Emergency Room，Integrated Department，Department of Pancreatic and Gastric Surgery，and Department of Thoracic Surgery were the top five departments where critical values were most frequently found. The proportion of inpatients with critical values after adjustment(59.89%) was significantly lower than that before adjustment(75.10%). The median laboratory turnover time of outpatient critical values after adjustment was significantly lower than that before adjustment(P=0.000). ［Conclusion］ Analyzing and evaluating critical values at regular intervals can provide reference for the continuous improvement of critical value management. |
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