CN103279654A - Phase dividing method of radiotherapy and chemotherapy standardization quality control indexes - Google Patents
Phase dividing method of radiotherapy and chemotherapy standardization quality control indexes Download PDFInfo
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- CN103279654A CN103279654A CN 201310186969 CN201310186969A CN103279654A CN 103279654 A CN103279654 A CN 103279654A CN 201310186969 CN201310186969 CN 201310186969 CN 201310186969 A CN201310186969 A CN 201310186969A CN 103279654 A CN103279654 A CN 103279654A
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Abstract
The invention discloses a phase dividing method of radiotherapy and chemotherapy standardization quality control indexes. The phase dividing method divides the radiotherapy and chemotherapy standardization quality control indexes into five phases including (1) a first phase, namely a period before radiotherapy and chemotherapy, (2) a second phase, namely a period during the radiotherapy and the chemotherapy, (3) a third phase, namely a treatment interval of the radiotherapy and the chemotherapy, (4) a fourth phase, namely follow-up visiting, and (5) a fifth phase, namely auxiliary quality control. According to the phase dividing method, phase-divided quality control index division is provided, only indexes of a corresponding part in each phase of diagnosis and treatment are required to be concerned, complexity of radiotherapy and chemotherapy standardization quality control is reduced, and efficient radiotherapy and chemotherapy standardization quality control assessment is facilitated.
Description
Technical field
The present invention relates to the stage division methods of chemicotherapy standardization quality control index.
Background technology
Radiation and chemotherapy is collectively referred to as chemicotherapy, is two kinds for the treatment of meanss that are widely used in malignant tumour.The radiation damage cell chromosome is used in radiotherapy, cell is stopped growing, and chemotherapy is killed tumour cell by medicine, normally by blocking cell division mechanism to suppress growth of cancer cells.Yet chemicotherapy also can kill the normal cell of human body when killing tumour cell, thereby causes the patient syndromes such as health is weak, immunity degradation, bone marrow suppression, gastricism to occur, and may be to each internal organs and nervous system toxic side effect.
Chemicotherapy need be set up and implement strict standardization quality assurance and quality control, goes to measure and the service quality of estimating the chemicotherapy process and result for the treatment of according to standard, and the execution of adopting measures necessary to ensure the quality of products and ensure.The standardization quality control index of chemicotherapy is a lot, generally comprised operation, pathology, by stages, genetic test, radiotherapy target area, technology and the dosage of targeted drug, efficacy evaluation, toxic and side effect, through peripheral vein puncture central vein catheter art (PICC), follow up a case by regular visits to etc.A complete chemicotherapy standardization quality control will be estimated all quality control indexs.
Yet quality control index is a lot, covered the overall process of whole chemicotherapy, and the patient the different stages only to part quality control index sensitivity wherein, consider that simultaneously all quality control indexs can cause interference to actual specification quality control execution, therefore need effectively classify to quality control index, to determine need the standardize index item of quality control of current state.
Summary of the invention
The object of the present invention is to provide a kind of stage division methods of chemicotherapy standardization quality control index.
The technical solution adopted in the present invention is:
A kind of stage division methods of chemicotherapy standardization quality control index is characterized in that, comprises following five stages:
A kind of stage division methods of chemicotherapy standardization quality control index is characterized in that, comprises following five stages:
Before 1 phase one was chemicotherapy, the quality control index in this stage comprised following aspect:
1.1 implement the clinical stages inspection before the operation;
1.2 clear and definite pathological diagnosis before chemotherapy, the radiotherapy;
1.3 detect and record tumour and peripheral situation in the operation;
1.4 pathologic finding is preserved correct;
1.5 the pathological replacement of excision focus is complete;
During 2 subordinate phase were chemicotherapy, the quality control index in this stage comprised following aspect:
2.1 implement the clinical stages inspection before chemotherapy or the radiotherapy;
2.2 before using the targeted drug treatment, implement the Kras genetic test;
2.3 radiotherapy target area, technology and dosage record;
2.4 art is preceding or the postoperative chemicotherapy meets standard;
2.5 terminal cancer chemotherapy indication and Scheme Choice meet standard;
3 phase IIIs were chemicotherapy treatment interval, and the quality control index in this stage comprises following aspect:
3.1 implement therapeutic evaluation after the chemotherapy late period;
3.2 continue the bad reaction evaluation after chemotherapy, the radiotherapy;
4 quadravalence sections are for following up a case by regular visits to, and the quality control index in this stage comprises following aspect:
4.1 regularly carry out hematological examination;
4.2 regularly carry out imaging examination;
5 five-stages are quality of assistance control, and the quality control index in this stage comprises following aspect:
5.1 patient health education;
5.2 patient's length of stay and hospitalization cost;
5.3 nursing is safeguarded with PICC;
5.4 mental nursing;
5.5 chemicotherapy propaganda and education.
The beneficial effect that the present invention has is: the stage of chemicotherapy standardization quality control index divides by analyzing the standardization quality control of whole chemicotherapy, the quality control index that proposes is stage by stage divided, only need pay close attention to the index of appropriate section in each stage of diagnosis and treatment, reduce the complexity of chemicotherapy standardization quality control, be conducive to the quality control of chemicotherapy standardization efficiently assessment.
Description of drawings
Fig. 1 is the stage division methods synoptic diagram of chemicotherapy standardization quality control index of the present invention.
Embodiment
Method of the present invention with chemicotherapy standardize quality control index be divided into for before the chemicotherapy, during the chemicotherapy, chemicotherapy treatment at interval, follow up a case by regular visits to and quality of assistance five stages of control, as shown in Figure 1.
Before phase one was chemicotherapy, the diagnosis and treatment before chemicotherapy belonged to clinical means such as first visit, inspection, operation, do not relate to concrete chemicotherapy content, and the quality control index in this stage comprises following aspect:
1. implement the clinical stages inspection before the operation, be divided into three in former position, liver and lung, evaluation index has before the art to finish before assessment, the art finishes three assessments before finishing two assessments, art before an assessment, the art.Add up the accounting of sum, sub-item respectively.
2. clear and definite pathological diagnosis before the chemotherapy, radiotherapy, quality control index has: pathology is not made a definite diagnosis before the chemotherapy, pathology is made a definite diagnosis before the chemotherapy, pathology is not made a definite diagnosis before the radiotherapy, pathology is made a definite diagnosis before the radiotherapy, pathology is not made a definite diagnosis before the chemicotherapy, pathology is made a definite diagnosis before the chemicotherapy.Add up the accounting of sum, sub-item respectively.
3. detect and record tumour and peripheral situation in the operation, be divided into former position, liver, pelvic cavity, four records of regional lymph nodes are complete, and quality of evaluation control index has respectively: sum, 0 complete accounting of operation record, 1 complete accounting of operation record, 2 complete accountings of operation record, 3 complete accountings of operation record, 4 complete accountings of operation record, the lacuna sum is divided into four sub-projects again, is specially regional lymph nodes, pelvic cavity, liver, primary tumor.
4. 10% neutral formalin damping fluid is adopted in the preservation of pathologic finding, comprises quantity, accounting.
5. excise sample pathological replacement content, be divided into type substantially, differentiation, invade the profit degree of depth, incisxal edge, vascular nerves is invaded five, quality of evaluation control index has respectively: sum, 1 complete accounting of excision sample pathological replacement, 2 complete accountings of excision sample pathological replacement, 3 complete accountings of excision sample pathological replacement, 4 complete accountings of excision sample pathological replacement, excision sample pathological replacement 5 complete accountings, lacuna sum have and are divided into five sub-projects, for vascular nerves is invaded profit, cardinal principle type, differentiation, invasive depth, incisxal edge situation.
During subordinate phase was chemicotherapy, the patient accepted the chemicotherapy treatment in this stage, and the quality control index in this stage comprises following aspect:
1. implement the clinical stages inspection before chemotherapy or the radiotherapy, be divided into three in former position, liver and lung, quality control index has: finish before assessment, the radiotherapy before the radiotherapy to finish before an assessment, the radiotherapy to finish before two assessments, the radiotherapy to assess before three assessments, the chemotherapy, finish before the chemotherapy to finish before an assessment, the chemotherapy to finish before two assessments, the chemotherapy to assess before three assessments, the complex treatment, finish before the complex treatment and finish three assessments before finishing two assessments, complex treatment before an assessment, the complex treatment.Add up the accounting of sum, sub-item respectively.
2. implement the Kras genetic test before using the targeted drug treatment, quality control index has: targeted therapy does not have RAS to be measured, and targeted therapy has RAS to measure, the no RAS of Erbitux treatment measures, the Erbitux treatment has RAS to measure, and the no RAS of Avastin treatment measures, and the Avastin treatment has RAS to measure.Add up sum and the accounting of whether measuring respectively.
3. radiotherapy target area, technology and dosage record comprise that radiotherapy is complete according to open country and two records of dosage, and quality control index has: sum, preceding 0 the complete accounting of radiotherapy, preceding 1 the complete accounting of radiotherapy, preceding 2 the complete accountings of radiotherapy.
Before the art or the postoperative chemicotherapy meet standard, middle middle or low rectal carcinoma as T3 and/or N+, be evaluated as T3, the chemicotherapy of the N+ carcinoma of the rectum, quality control index has: mid-low rectal cancer has and do not have treatment before the art before the art by stages, mid-low rectal cancer has does not have treatment before the art before the art by stages, mid-low rectal cancer has treatment before the art before the art by stages.
5. terminal cancer chemotherapy indication and Scheme Choice meet standard, and quality control index has: NACT standard, NACT are lack of standardization, new adjuvant chemotherapy standard, new adjuvant chemotherapy are lack of standardization, late period NACT standard, late period NACT lack of standardization.Add up sum and standard whether accounting respectively.
Phase III is chemicotherapy treatment interval, and the patient enters this stage after finishing the one-period treatment, needs the curative effect of assessment chemicotherapy this moment, and with the diagnosis and treatment project of definite next stage, the quality control index in this stage comprises following aspect:
1. implement therapeutic evaluation after the chemotherapy in late period, quality control index has: accept the effective in cure evaluation of 2 above chemotherapy in the late period course for the treatment of, accept 2 above chemotherapy inefficacy evaluations in the late period course for the treatment of.
2. continue the bad reaction evaluation after chemotherapy, the radiotherapy, quality control control index has: radiotherapy has the toxicity record, and radiotherapy does not have the toxicity record, and chemotherapy has the toxicity record, and chemotherapy does not have the toxicity record.Add up sum respectively and non-registered accounting is arranged.
The quadravalence section enters this stage for following up a case by regular visits to after the patient finishes chemicotherapy, still need periodic review this moment, and the quality control index in this stage comprises following aspect:
1. whether hematological examination is made regular check on, and as routine blood test, swollen mark, hepatic and renal function, electrolyte etc., all needs every 2-3 month to check.
2. whether imaging examination is made regular check on, as CT, MRI, EUS, ECT, PETCT.
Five-stage is quality of assistance control, and quality of assistance control index is during the whole chemicotherapy, and the quality control index in this stage comprises following aspect:
1. patient health education, quality control index comprises: nutrition, physiology, disease cause, health education are specially the health education before the purpose, diagnosis and treatment of health education, the health education of diagnosis and treatment process, the health education after the diagnosis and treatment.
2. patient's length of stay and hospitalization cost, quality control index has: national average time in hospital sky, operation average time in hospital sky, chemotherapy average time in hospital sky, radiotherapy average time in hospital sky.
3. nursing safeguards that with PICC quality control index has: Nursing care of pain, PICC health education, CVP education.
4. mental nursing, quality control index has: outpatients mental state is learned education, the education of social support system.
5. chemicotherapy propaganda and education, quality control index has: the spinoff of radiotherapy, the toxic and side effect propaganda and education of chemotherapy.
Claims (1)
1. the stage division methods of a chemicotherapy standardization quality control index is characterized in that, comprises following five stages:
1.1 before the phase one was chemicotherapy, the quality control index in this stage comprised following aspect:
1.1.1 implement the clinical stages inspection before the operation;
1.1.2 clear and definite pathological diagnosis before chemotherapy, the radiotherapy;
1.1.3 detect and record tumour and peripheral situation in the operation;
1.1.4 pathologic finding is preserved correct;
1.1.5 the pathological replacement of excision focus is complete;
1.2 during subordinate phase was chemicotherapy, the quality control index in this stage comprised following aspect:
1.2.1 implement the clinical stages inspection before chemotherapy or the radiotherapy;
1.2.2 before using the targeted drug treatment, implement the Kras genetic test;
1.2.3 radiotherapy target area, technology and dosage record;
1.2.4 art is preceding or the postoperative chemicotherapy meets standard;
1.2.5 terminal cancer chemotherapy indication and Scheme Choice meet standard;
1.3 the phase III is chemicotherapy treatment interval, the quality control index in this stage comprises following aspect:
1.3.1 implement therapeutic evaluation after the chemotherapy late period;
1.3.2 continue the bad reaction evaluation after chemotherapy, the radiotherapy;
1.4 the quadravalence section is for following up a case by regular visits to, the quality control index in this stage comprises following aspect:
1.4.1 regularly carry out hematological examination;
1.4.2 regularly carry out imaging examination;
1.5 five-stage is quality of assistance control, the quality control index in this stage comprises following aspect:
1.5.1 patient health education;
1.5.2 patient's length of stay and hospitalization cost;
1.5.3 nursing is safeguarded with PICC;
1.5.4 mental nursing;
1.5.5 chemicotherapy propaganda and education.
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105205352A (en) * | 2015-08-20 | 2015-12-30 | 中国人民解放军第二军医大学 | Clinical evaluation method for primary liver cancer patient |
| CN108133300A (en) * | 2016-11-30 | 2018-06-08 | 北京经纬传奇医药科技有限公司 | A kind of clinical test quality evaluation system and its method |
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- 2013-05-20 CN CN 201310186969 patent/CN103279654A/en active Pending
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105205352A (en) * | 2015-08-20 | 2015-12-30 | 中国人民解放军第二军医大学 | Clinical evaluation method for primary liver cancer patient |
| CN108133300A (en) * | 2016-11-30 | 2018-06-08 | 北京经纬传奇医药科技有限公司 | A kind of clinical test quality evaluation system and its method |
| CN108133300B (en) * | 2016-11-30 | 2021-10-29 | 北京经纬传奇医药科技有限公司 | Clinical test quality evaluation system and method thereof |
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Application publication date: 20130904 |