心血管内科专科会诊现状分析  

Current situation analysis of specialist consultation in cardiovascular medicine department

作　　者：宋小武 王晋丽[2] 郜玲[2] 董颖[2] 石亚君[2] 李昕[3] Song Xiao-wu;Wang Jin-li;Gao Ling;Dong Ying;Shi Ya-jun;Li Xin(Outpatient Department,Service Center of the Ministry of Agriculture and Rural Affairs,Beijing 100125;Department of Cardiovascular Medicine,the First Medical Center,PLA General Hospital,Beijing 100853,China;Department of Quality Management,the First Medical Center,PLA General Hospital,Beijing 100853,China)

机构地区：[1]农业农村部机关服务局门诊部,北京100125 [2]解放军总医院第一医学中心心血管内科,北京100853 [3]解放军总医院第一医学中心质量管理科,北京100853

出　　处：《实用心电学杂志》2020年第5期335-339,共5页Journal of Practical Electrocardiology

基　　金：北京市科委医药协同科技创新研究项目(Z181100001918011)。

摘　　要：目的调研心血管内科专科会诊现状,梳理目前存在的问题,提出可行性措施,以提高会诊质量。方法选择解放军总医院各临床科室申请的心血管内科专科会诊为研究对象,应用我院电子病历管理系统(PRIDE系统)统计在线申请的心血管内科会诊,并追踪48 h内完成会诊的病例,收集患者基本信息、心电图诊断及会诊目的等信息。依据申请会诊所在科室,将会诊病例分为外科、内科、急诊科和肿瘤科4类。结果共入选会诊病例583例,其中外科393例,占67.4%;内科96例,占16.5%;急诊科80例,占13.7%;肿瘤科14例,占2.4%。会诊量排名前5位的科室依次为骨科(93例,占16.0%)、急诊科(79例,占13.6%)、泌尿外科(58例,占9.9%)、普通外科(54例,占9.3%)和肝胆外科(52例,占8.9%)。非急诊科住院患者主要会诊目的是协助诊断治疗(42.7%)、单纯心电图异常诊断(27.4%)、术前常规会诊(15.7%)和原有及疑似心脏疾病患者诊治(14.1%)。急诊科患者的主要会诊目的为原有及疑似心脏疾病诊治。因心电图异常会诊病例中,除2种及以上心电异常外,T波改变占比最高,达15.1%;其次为窦性心律不齐,占11.5%。结论心血管内科专科会诊需求量大,但实际上必要的专业会诊只占其中很小一部分,未来能否减少程序性会诊有待进一步研究。Objective To investigate the current situation of specialist consultation in cardiovascular medicine department,find out the existing problems,and to propose feasible measures to improve its quality.Methods The cardiovascular consultation application cases were selected from each clinical department of the PLA General Hospital.The electronic medical record management system(PRIDE system)of our hospital was used to obtain statistical data of online cardiovascular consultation applications.Those patients who had completed consultation within 48 hours were traced,and their basic information,ECG diagnosis and consultation purposes were collected.According to the original department before consultation application,the consultation cases were divided into four categories—surgical department,internal medicine department,emergency department and oncology department.Results A total of 583 consultations are selected,of which 393(67.4%)are surgical cases,96 cases(16.5%)are from internal medicine department,80 cases(13.7%)are from emergency department,and 14 cases(2.4%)are from oncology department.The top five departments ranked by consultation amount are department of orthopedics(93 cases,accounting for 16.0%),emergency department(79 cases,accounting for 13.6%),department of urinary surgery(58 cases,accounting for 9.9%),department of general surgery(54 cases,accounting for 9.3%)and department of hepatobiliary surgery(52 cases,accounting for 8.9%)in turn.Specialist consultations for non-emergency inpatients are mainly out of the purposes of diagnosis and treatment assistance(42.7%),simple ECG abnormality diagnosis(27.4%),routine pre-operation consultation(15.7%),and diagnosis and treatment of original and suspected heart diseases(14.1%).The main consultation purpose of the emergency department cases is the diagnosis and treatment of original and suspected heart diseases.Among those consultation cases due to ECG abnormalities,except for two or more ECG abnormalities,the proportion of T-wave changes is the highest,accounting

关 键 词：心血管内科 会诊 现状 

分 类 号：R540.4[医药卫生—心血管疾病]