医院实行急救医疗小组制度的观察研究  

Observational study of the implementation of medical emergency team in hospital

作　　者：赵丽薇 姜利 朱波[3] 董秉生 席修明[3] Zhao Liwei;Jiang Li;Zhu Bo;Dong Bingsheng;Xi Xiuming(School of Public Health,Capital Medical University,Beijing 100069,China;Department of Intensive Care Unit,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Intensive Care Unit,Fuxing Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学公共卫生学院,北京100069 [2]首都医科大学宣武医院重症医学科,北京100053 [3]首都医科大学附属复兴医院重症医学科,北京100038

出　　处：《中华危重病急救医学》2020年第3期362-366,共5页Chinese Critical Care Medicine

基　　金：国家科技支撑计划项目(2012BAI11B05)。

摘　　要：目的:分析首都医科大学附属复兴医院急救医疗小组(MET)的实施情况,了解呼叫MET的时间、科室、疾病、原因等特点,为改进MET的救治效果提供依据。方法:采用回顾性观察性研究方法,收集2015年1月1日至2018年12月31日首都医科大学附属复兴医院经MET治疗的呼叫记录。记录呼叫MET的季度、时间,MET救治患者的性别、年龄、入院时间、科室、入院诊断、呼叫原因,以及MET到达后的现场操作和结局等信息。结果:2015至2018年4年间共呼叫MET 846次,第一、第三季度呼叫比例相对较高,分别占28.0%(237/846)和26.5%(224/846);呼叫时间主要集中在日间08:00—19:59,占72.2%(611/846)。在MET救治的患者中,男性占64.3%(544/846),多于女性的35.7%(302/846);以60岁以上老年人为主,且随年龄增长MET救治比例逐渐增加,主要集中在80~89岁人群,占51.5%(436/846)。呼叫MET的科室主要为内科〔80.5%(681/846)〕、外科〔18.8%(159/846)〕和妇产科〔0.7%(6/846)〕;入院诊断前3位疾病依次为呼吸系统疾病〔31.6%(267/846)〕、神经系统疾病〔20.8%(176/846)〕和循环系统疾病〔9.9%(84/846)〕。呼叫MET原因分析显示,在生命体征异常记录中,以脉搏血氧饱和度(SpO2)异常比例最高〔27.8%(235/846)〕。经MET抢救后,7.3%(62/846)的患者当场死亡,48.7%(412/846)转入重症监护病房(ICU)进一步治疗,另有41.9%(354/846)的患者留在本科继续观察。结论:2015至2018年首都医科大学附属复兴医院MET启动情况在各年间相对稳定,多集中在第一、第三季度日间08:00—19:59;MET救治患者多为80~89岁男性,以内科呼吸系统疾病为主,SpO2异常出现最多。在之后MET的实施中可根据以上特点在管理上加以侧重。Objective To analyze the implementation of medical emergency team(MET)in Fuxing Hospital of Capital Medical University,and to investigate the characteristics such as the time,department,disease,cause of the MET calls,in order to provide a basis for the improvement of MET's implementation.Methods A retrospective study was conducted.MET calls that received between January 1st,2015 and December 31st,2018 at Fuxing Hospital were collected.The calls'information included the quarter,time,and the patients'gender,age,admission time,department,admission diagnosis,the reason for the calls,the operation and outcome of the MET upon arrival.Results A total of 846 MET calls were occurred during 4 years from 2015 to 2018.The frequencies of the first and third quarter were relatively high with 28.0%(237/846)and 26.5%(224/846),respectively.The events mainly occurred during the day(08:00-19:59)with 611 calls(72.2%).There were more men[64.3%(544/846)]than women[35.7%(302/846)].The calls were mainly from the elderly over 60 years old,and gradually increased with age,which distributed the most in patients aging 80-89 years old,accounting for 51.5%of all calls(436/846).Among all the MET events,80.5%(681/846)were from department of internal medicine,18.8%(159/846)were from department of surgery,and 0.7%(6/846)were from department of gynecology and obstetrics.The top 3 diseases reported in the calls were respiratory diseases[31.6%(267/846)],nervous system diseases[20.8%(176/846)]and circulatory diseases[9.9%(84/846)].The reason of MET calls showed that abnormal pulse oxygen saturation[SpO2,27.8%(235/846)]were the most among 4 vital signs.After MET rescue,7.3%(62/846)of the patients died,48.7%(412/846)were transferred to intensive care unit(ICU)for further treatment,and 41.9%(354/846)remained under observation.Conclusions The frequency of MET calls in Fuxing Hospital of Capital Medical University was relatively stable over the years,mostly received in the daytime(08:00-19:59)of the first and third quarter.Most of the patients were male a

关 键 词：急救医疗小组 早期预警 呼叫 实施情况 

分 类 号：R45[医药卫生—治疗学]