诊疗规范能否规避腹部钝性伤救治中的风险  

Whether diagnostic and treatment norms can avoid risks in the treatment of blunt abdominal injuries

作　　者：张连阳[1] ZHANG Lian-yang(Trauma Center, State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing 400042, Chin)

机构地区：[1]第三军医大学大坪医院野战外科研究所全军战创伤中心、创伤、烧伤与复合伤国家重点实验室,重庆400042

出　　处：《创伤外科杂志》2017年第5期321-324,共4页Journal of Traumatic Surgery

基　　金：国家科技支撑计划“创伤救治新技术研究及集成示范”(2012BAI11B01);国家科技惠民计划“面向重庆典型区县常见伤病适宜技术的示范应用”(2013GS500101)

摘　　要：临床实践中,医师如果不遵循规范选择某项诊疗技术,则可能存在局限性,容易造成诊治方案的偏差和不一致性,甚至危及医疗安全。本文阐述诊疗规范的概念,分别介绍了国家政府、行业组织、教材专著和医疗机构等层面各类规范的特点和存在问题。以钝性脾损伤为例,指出遵循规范规避腹部钝性伤诊疗风险的初次评估方法,区分血流动力学稳定和不稳定患者的不同救治流程。提出了对现有规范分门别类,减少重复性,增加权威性;积极宣讲、示范规范,评价其实施效果;并注意区分诊疗规范与精益求精的医疗行为等。In clinical practice,if physicians do not follow the norms to select the treatment technology, the resulting limitations may cause bias and inconsistency of diagnosis and treatment, and even endangering the safety of health care. This paper describes the concept of norms for diagnosis and treatment, introduces the characteristics and problems of norms from the level of national governments, trade organizations, teaching monographs and medical in- stitution. The author takes blunt splenic injuries as an example, describes the initial assessment method to follow the norms to avoid the risk of blunt abdominal trauma treatment, and distinguishes different treatment processes for he- modynamically stable and unstable patients. Finally, the author advises to classify the existing norms, reduce the du- plication ,increase the authority, actively promote the application of norms and apply demonstration and evaluate its effectiveness. Also, the author advises to pay attention to distinguishing differences between diagnostic and treatment norms and improvement of medical practices.

关 键 词：腹部钝性伤 脾损伤 诊疗规范 

分 类 号：R656[医药卫生—外科学]