中国大型综合性医院肺量计检查报告质量的多中心调查

目的 了解我国肺量计检查报告质最控制现状.方法 收集2008年1-10月我国36家大型综合性医院肺功能室的肺量计检查报告单,参照ATS和ERS的肺活量测试标准进行质量分析,肺量计检查各质量控制标准的符合情况以百分率来描述.结果 共收集345例报告单,82.5%(282/342)的报告单符合测试起始质量的标准;65.8%(219/333)的报告单达到分析呼气流畅质量的标准,其余114例不符合标准的报告单中,咳嗽占8.7%(29/333),声门早闭占2.4%(8/333),口嘴漏气占8.7%(29/333),提前中止占7.8%(26/333),阻塞口器占1.8%(6/333),未尽最大努力占14.7%(49/333);50.6%(119/235)的报告单达到分析测试结束质量的标准;测试次数≥3次的占22.6%(78/345),其中65例有各次测试数据报告,可分析其重复性,符合标准的占95.4%(62/65),占总数的18.0%(62/345),AFVC＜150 ml的占95.4%(62/65),△FVC＜100 ml的占92.3%(60/65),△FEV_1＜150 ml的占100.0%(65/65),△FEV_1＜100 ml的占87.7%(57/65);在345例报告单中,同时符合上述4项标准的仅占总数的7.2%(25/345).结论 我国医院的用力肺功能检查质量有待提高.

Investigation on quality of spirometry in 36 large hospitals in China

Objective To assess the current status of quality control of spirometry reports in China.Methods Spirometry case reports from January 2008 to October 2008 were collected from pulmonary function testing laboratories in 36 large hospitals (provincial or municipal) in China.The quality analysis was performed according to ATS/ERS standardization for measurement of spirometry.The number of reports that met the criteria for quality control was expressed as percentages.Results A total of 345 spirometry test reports were collected.82.5% (282/342) met the start-of-test criteria for quality control.333 reports could be analyzed for free of artifacts,of which 65.8% (219/333) were consistent with the criteria of smooth expiration;the remaining reports (114) failed to meet the criteria,for reasons including cough (29/333,8.7%),premature glottis closure (8/333,2.4%),gas leakage (29/333,8.7%),early termination of expiration (26/333,7.8%),mouthpiece obstruction (6/333,1.8%),and incomplete exertion of efforts (49/333,14.7%).235 reports were analyzed for end-of-test criteria,with 50.6% (119/235) complying to criteria.22.6% (78/345) of the reports were tested for more than 3 times,among which 65 reports with the data of each manoeuvre could be analyzed for repeatability.95.4% (62/65) of the reports met the repeatability criteria,which accounted for 18.0% (62/345)of the total reports collected.The rate of the 2 highest FVC (forced vital capacity) and FEV_1 (forced expiratory volume in one second) of less than 150 ml was 95.4% (62/65) and 100.0% (65/65),respectively.The rate of the 2 highest FVC and FEV_1 of less than 100 ml was 92.3% (60/65) and 87.7% (57/65),respectively.Only 7.2% of the reports (25/345)met all of the 4 criteria listed above.Conclusions The quality of spirometry tests in large (provincial or municipal) hospitals in China needs to be improved in the future.