Course, culture and echelon
The specialty of kidney disease in our hospital was founded in 1976. After several generations of unremitting efforts, the talent echelon is constantly improved, the sub specialty is gradually complete, the equipment and technology are gradually upgraded, and medical treatment, scientific research and teaching are carried out simultaneously. At present, under the background of Internet plus medical treatment, the management mode of "intelligent nephrology" has been implemented in our hospital.
Since its independent establishment in 2002, after 17 years of rapid development, the nephrology department has become a affiliated unit of "quality management and control center of blood purification in Hebei Province", the "Management Branch of blood purification center of Hebei Hospital Association", "nephrology Professional Committee of Hebei Pharmaceutical Association" and "blood purification equipment and materials branch of Hebei Clinical Medical Engineering Association" At the same time, it is also the "key discipline of kidney medicine in Hebei Province", "key clinical specialty of kidney disease in Hebei Province", "national county hospital blood purification training base", and the first batch of national health and Health Commission "special capacity training base for hemodialysis". After years of efforts and efforts, the Department scale has grown unprecedentedly, and the sub specialty has been set up completely, which is divided into three kidney disease areas, one blood purification center (three areas), one kidney disease intensive care unit, one kidney disease management center, one peritoneal dialysis center, one kidney disease laboratory, one national drug clinical trial institution of kidney disease, and another tumor related kidney disease sub specialty Section. At present, it has developed into a five in one nephrology department with chronic kidney disease management as the source, blood purification as the leader, tumor related kidney disease as the feature, kicu as the guarantee and laboratory as the support.
The core group of the Department with the Department Director as the center has led 100 employees to form a high-quality talent echelon with exquisite technology and reasonable structure. All staff are highly unified in thinking, adhering to the scientific training of "upholding morality, upholding morality, practicing prudence", taking "integrity and pragmatism" as the working principle, taking "safety and efficiency" as the goal, taking "learning and innovation" as the driving force, and using the advanced concept and excellent professional technology of "standardized diagnosis and treatment, standardized operation, individualized management and humanized service" to provide patients with safety and high quality Efficient and cost-effective medical services.
Setting up of Nephrology subspecialty
①Blood purification
In 1984, the nephrology department of our hospital took the lead in developing blood purification technology in the province. With the completion of the new medical technology building, the newly expanded blood purification center was put into use in October 2018. The center is the largest single blood purification center in Hebei Province, and it also implements the intelligent management mode of Internet plus medical care. It adopts two modes of "self help dialysis" and "artificial admission". The center has 120 hemodialysis machines, 2 bipolar reverse osmosis non dead cavity heat disinfection water machines with data collection, central liquid supply system and various monitoring and evaluation equipment. The dialysis quality has leaped to the advanced ranks in China. At present, the annual average dialysis volume is more than 60000 cases, in addition, nearly 100 blood purification practitioners are trained for the whole province every year.
The construction of vascular access has been carried out for 15 years. At present, many technologies have been developed, such as autogenous arteriovenous fistulas, artificial arteriovenous fistulas, autogenous vascular transplantation, transposition arteriovenous fistulas, PTA under ultrasound / DSA, forgate catheter thrombectomy, high flow restriction of internal fistula, aneurysm resection and treatment of access infection.
②Kidney intensive care unit (kicu)
Kicu of our department was founded in 2010, with 8 beds, 19 medical staff and 2 respiratory therapists. Kicu is equipped with the most advanced non-invasive / invasive ventilator, continuous blood purifier, nasal feeding nutrition pump, infusion system, central monitoring system, invasive / non-invasive hemodynamic monitoring equipment, blood gas analyzer, BNP / NGAL detector, microcirculation detector and other diagnosis and monitoring equipment in the world. Under the support of professional kicu information management system, kicu realizes the diagnosis and monitoring of critical patients "Data" management, so as to achieve sustained, titrable precision treatment.
Kicu has gradually formed a unique diagnosis and treatment project on the basis of ICU, including severe AKI, perioperative management of uremic patients, diagnosis and treatment of critical complications / complications of uremic patients, diagnosis and treatment of severe kidney diseases and multidisciplinary application of severe blood purification technology. In addition, our department kicu regularly holds CRRT training courses every year, and undertakes all levels of hospital learning personnel to train talents for the field of severe kidney disease in and out of the province, and promotes the development of the sub major of severe kidney disease in our province.
③Nephrology Laboratory
The kidney disease laboratory was founded in 2003. It consists of five parts: the clinical examination room of kidney disease, the renal pathology room, the molecular biology laboratory, the physics examination room and the clinical GCP laboratory. At present, he is responsible for the examination of samples sent to the undergraduate department and other hospitals, as well as the basic research and clinical research of tumor related kidney diseases in our department.
At present, the laboratory carries out urine component analysis, early renal damage detection, kidney damage location determination, renal anemia detection, renal osteopathy detection, autoimmune detection, specific protein analysis, coagulation function panorama detection, blood gas analysis, membrane nephropathy identification detection, renal puncture pathology detection and other projects. Molecular biology laboratory is now mature, and has carried out primary cell culture, qRT-PCR, Western-blotting, cell transfection, RNA interference, two-dimensional gel electrophoresis, SNP site detection and other molecular biology or cell biology technology. At present, the functional examination room carries out non-invasive hemodynamic evaluation, nutritional evaluation, vascular endothelial function and degree of arteriosclerosis detection, AVF flow and recycling detection, dynamic blood pressure monitoring, ultrasound-guided renal biopsy and other inspection, monitoring and treatment projects.
④Nephrology Management Center
There are 3 doctors, 4 nurses, 1 nutritionist, 1 sports rehabilitation teacher and 1 pharmacist in nephrology management center. The center puts forward the management concept of "8-hour work, 24-hour management". With the help of the Internet and hospital management platform, the center carries out the whole process management on the patients with chronic kidney disease in stage 1-5, and gives the patients to develop personalized "four prescriptions" - drug prescriptions, nutrition prescriptions, sports rehabilitation prescriptions and patients' self-management prescriptions. Through the professional training of medical staff, with the help of the "four magic weapons" of patients' self-management - weight scale, sphygmomanometer, urine protein test paper, nutrition diet, improve patients' self-management ability, so as to achieve the core of chronic kidney disease management - patients' self-management.
The use of management software has changed the traditional diagnosis and treatment mode, improved the medical experience of patients, and realized the original intention of "only let patients with chronic diseases run once". Patients can search the results of laboratory tests, online consultation, medication guidance, self-management records and monitoring, nutrition and sports and other propaganda and education contents on the mobile phone, which promotes the concept change of chronic kidney disease from "simple diagnosis and treatment" to "comprehensive management".
⑤Peritoneal dialysis
The peritoneal dialysis center of Nephrology was established in 2010. At present, there are 2 doctors, 4 nurses and 1 nutritionist. There are more than 100 peritoneal dialysis patients. At present, continuous ambulatory peritoneal dialysis, peritoneal dialysis with peritoneal dialysis machine, IPD, CCPD, TPD and other peritoneal dialysis projects have been carried out, greatly improving the medical and life quality of patients. Continuous improvement and improvement in catheterization operation, taking the lead in the province to carry out the catheterization of CAPD by cannula and the catheterization of CAPD by Seldinger method, shorten the operation time, improve the success rate of operation, reduce the occurrence of intraoperative pain and postoperative complications, and create conditions for emergency peritoneal dialysis.
