目的 探讨智能病案质控系统对病案质量及质控效率的影响，为优化病案管理模式提供依据。方法 选取2024年4月—9月传统人工质控病案2 000份（对照组）与2024年10月—2025年6月智能病案质控系统辅助质控病案2 000份（研究组），对比两组缺陷检出率、编码准确率、内涵质量达标率等病案指标，以及人均日均处理量、质控耗时、漏检率等效率指标。结果 研究组缺陷检出率（15.20%）高于对照组（8.30%）；编码准确率（95.70%）、内涵质量达标率（93.50%）高于对照组（86.50%、82.30%）（均P＜0.05）；研究组人均日均处理量较对照组提升；单份病案质控耗时（4.80 min）缩短；漏检率（3.00%）降低62.50%（均P＜0.05）。结论 智能病案质控系统可提升病案质量与质控效率，优化医疗资源配置，为DRG/DIP支付改革提供支持。

      Objective To explore the influence of intelligent medical record quality control system on medical record quality and quality control efficiency，so as to provide a basis for optimizing medical record management mode．Methods A total of 2 000 traditional manual quality control medical records（control group）from April to September 2024 and 2 000 intelligent medical record quality control system-assisted cases（experimental group）from October 2024 to June 2025 were selected．The study compared key indicators including defect detection rates，coding accuracy，and connotation quality compliance rates，along with efficiency metrics such as daily per capita processing volume，quality control time consumption，and missed detection rate between the two groups．Results The experimental group showed a significantly higher defect detection rate（15.20%）compared to the control group（8.30%）．The coding accuracy（95.70%）and connotation quality compliance rate（93.50%）were notably higher than the those of control group（86.50% and 82.30%，P＜0.05）．The experimental group demonstrated improved daily processing capacity per capita，with a significant reduction in quality control time for individual medical records（4.80 minutes）and a 62.50% decrease in missed detection rate（3.00%，P＜0.05）．Conclusions Intelligent medical record quality control system can significantly improve the quality and quality control efficiency of medical records，optimize the allocation of medical resources，and provide support for DRG/DIP payment reform．

      目的  探讨通过优化病案首页质控体系提高误入DRG低权重组病例转出率的效果。方法  采用PDCA循环法，通过实施分层级编码培训、基于AI赋能的专项质控模式及智能化反馈机制构建等系统性地改进措施优化质控体系。通过对比分析质控系统优化前后（2022年1—7月和2023年1—7月）DRG低权重组病例的病案首页质控过程、“经质控低权重病例入组率”和“误入低权重组病例转出率”等指标，评估质控体系优化的实施效果。结果  质控体系优化后，低权重组病例转出率由3.27%提升至4.15%（P=0.018），经质控低权重病例入组率由16.98%降至14.96%（P＜0.001）。结论  AI赋能的专项质控、分层级编码培训与智能化反馈机制三项措施并举可以系统优化质控体系，进而提升DRG低权重组病例转出率。

       Objective  To investigate the effect of optimizing the medical  record front  page  quality control  system on improving the transfer-out rate of cases mistakenly assigned to low-weight DRG groups．Methods  The Plan-Do-Check-Act（PDCA）cycle methodology was employed．Systemic improvements were implemented to  optimize the medical  record front page quality control system，including hierarchical coding training，innovation of a  specialized quality control model based on AI empowerment，and establishment of an intelligent feedback mechanism．The implementation effectiveness was evaluated by comparative analysis of the following indicators before（January-July 2022）and after（January-July 2023）optimization：the medical record quality control process for low-weight DRG cases，the  rate of low-weight cases assigned to groups after quality control，and the transfer-out rate of cases mistakenly entering low-weight groups．Results  After optimizing the medical record front page quality control system，the transfer-out rate of cases from low-weight groups increased from 3.27% to 4.15%（P=0.018），while the rate of low-weight cases assigned to groups after quality control decreased from 16.98% to 14.96%（P＜0.001）．Conclusions  Implementing a three-pronged approach—AI-powered specialized quality control，hierarchical coding training，and an intelligent feedback mechanism—can systematically optimize the medical record front page quality control system，thereby improving the transfer-out rate of cases mistakenly assigned to low-weight DRG groups．

目的 探讨导航护士主导的三级质控在胸腔镜肺癌切除术患者加速康复中的应用效果。方法 选取2020年6月—2023年6月周口市中心医院收治的106例肺癌患者,应用随机数字表法分为观察组（n=53）与对照组（n=53）。患者均采取胸腔镜肺癌切除术治疗,对照组实施常规的术前、术中及术后相关围术期护理,观察组在常规围术期护理基础上增加导航护士主导的三级质控护理。对比两组住院时间、术后并发症和护理前后世界卫生组织生活质量-100量表（WHOQOL-100）及癌因性疲乏程度（PFS）,最后对比两组的护理满意度。结果 观察组首次排气时间、首次下床时间、术后疼痛视觉模拟量表（VAS）评分、术后住院时间均优于对照组（P<0.05）;观察组并发症发生率低于对照组（P<0.05）;干预后两组WHOQOL-100评分升高、PFS评分降低,观察组均优于对照组（P<0.05）;观察组护理满意度高于对照组（P<0.05）。结论 对胸腔镜肺癌切除术患者,采取导航护士主导的三级质控管理的加速康复护理,可促进患者术后肠胃功能恢复,缩短住院时间,减轻术后疼痛感与减少并发症,在改善患者癌因性症状的同时,提升其生活质量,提高患者护理满意度。

Objective To explore the application effect of three-level quality control led by navigation nurses in accelerating rehabilitation of patients undergoing thoracoscopic lung cancer resection．Methods A total of 106 lung cancer patients admitted to our hospital from June 2020 to June 2023 were selected and randomly divided into an observation group（n=53）and a control group（n=53）using a random number table method．All patients were treated with thoracoscopic lung cancer resection,while the control group received routine preoperative,intraoperative and postoperative perioperative care,the observation group received a three-level quality control nursing led by navigation nurses in addition to routine perioperative care．The length of hospitalization,postoperative complications,WHOQOL-100 and PFS before and after care,and the nursing satisfaction of the two groups were compared．Results The observation group had significantly shorter first exhaust time,first time out of bed,postoperative visual analogue scale（VAS）score and postoperative hospital stay compared to the control group（P<0.05）．The incidence of complications in the observation group was lower than that in the control group（P<0.05）．After intervention,the WHOQOL-100 scores of both groups increased,and the observation group was higher than the control group．The PFS score decreased,and the observation group was lower than the control group（P<0.05）．The nursing satisfaction of the observation group was significantly higher than that of the control group（P<0.05）．Conclusions Adopting a three-level quality control management led by navigation nurses to accelerate rehabilitation care for patients undergoing thoracoscopic lung cancer resection can promote postoperative recovery of gastrointestinal function,reduce hospitalization time,reduce postoperative pain and complications,improve cancer related symptoms,improve their quality of life and increase patients nursing satisfaction．

目的 探究质控预警系统在重症患儿连续性血液净化治疗的应用效果。方法 随机选取于2020年1月—2021年12月在我院进行连续性血液净化治疗的共80例重症患儿作为本次研究对象,将80例患儿随机分成研究组和对照组,对照组进行常规护理,研究组则在常规护理的基础上行预警系统质量控制,对比2组患儿连续性血液净化治疗时长及报警频次、2组患儿在不同治疗时间段内滤器凝血发生率、2组非计划下机发生情况及2组患儿家属的护理满意度。结果 研究组平均报警频次为(8.60±3.35),低于对照组(16.52±7.41)的报警频次。而研究组的治疗时长(32.54±6.73 h)较对照组(21.38±5.61 h)延长,研究组患儿在进行连续性血液净化治疗的过程中,在8小时至24小时之间及大于24小时滤器的凝血发生率低于对照组,研究组和对照组护理满意度分别为92.50%和75.00%,对比差异显著。结论 在对重症患儿进行连续性血液净化治疗过程中应用质控预警系统具有较高的临床使用价值,不仅可以有效降低报警频次及滤器凝血发生率,而且对延长治疗时间有显著的促进作用,值得在今后的治疗过程中大力推广。

Objective To explore the application effect of quality control early warning system in continuous blood purification treatment of critically ill children.Methods A total of 80 critically ill children who underwent continuous blood purification treatment in our hospital from January 2020 to December 2021 were randomly selected as the research object, and were randomly divided into observation group and control group.The control group received routine nursing,and the observation group received early warning system quality control on the basis of routine nursing.The duration and alarm frequency of continuous blood purification treatment,the incidence of filter coagulation in different treatment periods,the occurrence of unplanned quitting and nursing satisfaction of the two groups were compared.Results The average alarm frequency of the observation group was (8.60±3.35),which was significantly lower than that of the control group (16.52±7.41).However,the treatment duration of the observation group (32.54±6.73 h) was significantly longer than that of the control group (21.38±5.61 h).During continuous blood purification treatment,the incidence of blood coagulation in the observation group was lower than that of the control group,and the nursing satisfaction of the observation group and the control group were 92.50% and 75.00% respectively,with significant differences.Conclusions The application of quality control early warning system in the continuous blood purification treatment of critically ill children has a high clinical value,which can not only effectively reduce the alarm frequency and the incidence of filter coagulation,but also significantly prolong the treatment time,and it is worth promoting in the future treatment process.

目的 分析抽检血液成分关键指标结果并采用趋势分析方法进行评估。方法 收集整理2015—2017年每月1次的8种血液成分质量控制的检测数据,选择关键指标并制作折线图,联合行动限和警戒限进行趋势分析。结果 未能100%达到GB 18469—2012《全血及成分血质量要求》的项目包括悬浮红细胞容量及Hct、单采血小板及浓缩血小板血小板含量、新鲜冰冻血浆及冷沉淀VIII因子含量。新鲜冰冻血浆及冷沉淀的VIII因子含量项目分别出现10次和5次偏离数据;单采血小板及浓缩血小板的血小板含量项目分别出现3次和4次偏离数据。结论 根据血液成分的关键指标结果进行趋势分析发现问题,主动寻找原因并及时采取相应措施,是确保血液质量的一种有效手段。

Objective To analyze and evaluate the results of key indexes of the blood component by trend analysis. Methods Collected and arranged the data of eight kinds of blood component quality control,which was did once month in 2015-2017.Selected the key indexes and made the line charts.Allied with the action limits and warning limits for trend analysis. Results The key indexes could not 100% meet the “Quality requirements for whole blood and component blood”,including capacity and Hct of suspended red blood cell,platelet content of apheresis platelets and platelets concentrate,factor VIII content of fresh frozen plasma and cryoprecipitate.The factor VIII of fresh frozen plasma and cryoprecipitate showed ten and five deviation data, respectively, the platelet content of apheresis platelet and platelets concentrate showed three and four deviations, respectively. Conclusion It's an effective way to ensure blood quality by trend analysis based on the results of key indexes of blood components, and actively find the cause and take corresponding measures in time.