品管圈在降低肝硬化患者拔除腹腔置管后渗液率中的应用
摘要
<正>腹腔积液是肝硬化常见并发症。约60%的肝硬化患者在诊断10年后可能有腹腔积液。低盐饮食和大量利尿剂(螺内酯400 mg/d,速尿160 mg/d)不能有效缓解腹腔积液症状或在腹腔积液引流后短时间内复发时,称为顽固性腹腔积液~([1])。大量腹腔积液时因为腹内压增大导致呼吸困难、气紧和端坐呼吸,甚至胸腔积液,是导致肝硬化患者入院最常见的并发症[2,3],我科通常采用腹腔置管方法治疗顽固性腹腔积液,但拔管后穿刺点渗液常有发生,渗液导致伤口敷料过湿、皮肤浸渍,增加感染风险。目前,主要封堵方法为无菌纱布加压包扎,但效果较差。品管圈(QCC)是指同一场所、相似性质的基层员工,自动自发形成一个团队进行质量管理活动,运用各
引文
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[5] Liu T. Review of QCC of Chinese hospitals[J]. J Chin Res Hospitals,2015,2:24-28.
[6]王红玉.胸腹腔引流管拔除后伤口愈合不良的影响因素及预见性干预方案探究[D].苏州:苏州大学,2014.
[7]李贝贝,常晋玲.腹腔穿刺术后腹水外渗的几种护理方式[J].世界临床医学,2016,10(2):1.
[2] Planas R,Montoliu S,Ballest B,et al. Natural history of patients hospitalized for management of cirrhotic ascites[J]. Clin Gastroenterol Hepatol,2006,4:1385-1394.
[3] Runyon BA,AASLD. Introduction to the revised American Association for the Study of Liver Diseases Practice Guideline management of adult patients with ascites due to cirrhosis 2012[J].Hepatology,2013,57(4):1651-1653.
[4]张幸国,王林润,刘勇,等.医院品管圈辅导手册[M].北京:人民卫生出版社,2012:4.
[5] Liu T. Review of QCC of Chinese hospitals[J]. J Chin Res Hospitals,2015,2:24-28.
[6]王红玉.胸腹腔引流管拔除后伤口愈合不良的影响因素及预见性干预方案探究[D].苏州:苏州大学,2014.
[7]李贝贝,常晋玲.腹腔穿刺术后腹水外渗的几种护理方式[J].世界临床医学,2016,10(2):1.