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目的探讨提高职业病患者肺功能检查配合程度的有效管理模式。方法应用危害分析与关键控制点(HACCP)理论对消极配合(包括被动或不配合)肺功能检查的患者进行风险管理,以普通患者为对照(对照组),评估分析职业病和疑似职业病患者(观察组)消极配合肺功能检查危害环节,找出显著危害的关键控制点,提出预防措施,建立有效监控系统。结果 HACCP理论实施前,观察组肺功能检查配合率(68.8%)低于对照组(88.7%,P<0.001)。HAC-CP理论实施后,观察组肺功能检查配合率(84.1%)高于实施前(68.8%,P<0.01),与同期对照组(89.4%)比较,差异无统计学意义(P>0.05);观察组的消极配合检查患者中,因担心诊断不上职业病或者评定不上更高级别伤残等级的患者构成比(61.1%)较HACCP理论实施前(83.3%)下降,差异有统计学意义(P<0.05)。结论应用HACCP理论进行干预,能够有效防范职业病患者消极配合肺功能检查管理风险,提高管理效率。
Objective To explore an effective management model to improve the coordination of pulmonary function tests in patients with occupational diseases. Methods HACCP was used to manage the risk of negatively cooperating (including passive or uncooperative) pulmonary function tests, and the general patients were taken as control (control group) to evaluate the analysis of occupational diseases and suspected occupational diseases Group) Negative links with the lung function check hazards, identify the key hazards of significant control points, put forward preventive measures, the establishment of an effective monitoring system. Results Before the implementation of HACCP theory, the lung function test in the observation group (68.8%) was lower than that in the control group (88.7%, P <0.001). After HAC-CP theory was implemented, the rate of pulmonary function test in the observation group was significantly higher than that of the control group (84.1% vs 68.8%, P <0.01), but there was no significant difference between the two groups (P> 0.05) ). The proportion of patients with adverse reactions in the observation group (61.1%) who were not diagnosed as having occupational disease or were not rated as higher grade disability was significantly lower than that before HACCP (83.3%), with statistical difference Significance (P <0.05). Conclusion The intervention of HACCP theory can effectively prevent occupational disease patients from negatively cooperating with the risk management of pulmonary function tests and improve the management efficiency.