重症医学亚专科建设5年运行状况分析——基于贵州医科大学附属医院重症医学科的数据分析  

Analysis on the operation status of subspecialty of critical care medicine of hospital affiliated to Guizhou Medical University in the past 5 years

作　　者：谭万林 刘颖 王迪芬 Tan Wanlin;Liu Ying;Wang Difen(Department of Critical Care Medicine,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学附属医院重症医学科,贵阳550004

出　　处：《中华危重病急救医学》2022年第3期289-293,共5页Chinese Critical Care Medicine

基　　金：国家重点研发计划(2018YFC2001900-04);国家临床重点专科建设项目(2011-170);贵州省临床重点学科建设项目(2011-52);贵州省高层次人才专项资助基金(TZJF-2011-25)。

摘　　要：目的:通过回顾性分析贵州医科大学附属医院重症医学科亚专科建设5年来患者的收治情况,为重症医学亚专科的建设提供依据。方法:收集2016年1月1日至2020年12月31日贵州医科大学附属医院重症医学科收治患者的临床资料,包括性别、年龄、首诊科室、重症监护病房(ICU)住院时间、呼吸机使用时间、主要诊断、转入和转出ICU时急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、治疗结果、是否给予机械通气、是否使用无创呼吸机辅助呼吸、24 h内死亡情况、抢救次数及成功率等,分析5年间上述指标的变化。结果:5年来,本院以重症神经、重症循环、重症创伤为主要收治范围的重症医学科共救治患者2668例,其中男性1648例,女性1020例;年龄6个月~94岁,平均(53.49±19.03)岁;首诊最多的科室为神经外科(907例);病种前3位分别为脑出血(539例)、脓毒性休克(214例)、低血容量性休克(200例);ICU住院时间126(52,253)h,使用呼吸机时间65(17,145)h,转入和转出ICU时APACHEⅡ评分为(23.29±8.12)分和(12.99±6.37)分;接受机械通气的比例为92.94%(2147/2310),其中使用无创呼吸机314例;24 h死亡84例(病死率为3.15%),共抢救2585次,抢救成功率为92.84%(2400/2585);2016至2020年5年治愈率分别为65.92%、65.83%、61.53%、65.64%、69.06%,5年病死率分别为13.13%、14.29%、18.89%、16.69%、13.38%。结论:随着重症医学的不断发展和壮大,分类后建立的亚专科可以集中收治患者,使得治疗能够专业化及规范化,提升治愈率,降低病死率;同时医务人员可以集中管理及学习相关专科知识,对疾病掌握也更加深入,有助于医生的自我提升和对于相关亚专业的精通,为科室的发展奠定良好的基础。Objective Through retrospective analysis of the admission and treatment of patients in the department of critical care medicine of the Affiliated Hospital of Guizhou Medical University over the past 5 years,it provides a basis for the construction of the subspecialty of intensive care medicine.Methods Collect clinical data of patients admitted to the department of critical care medicine of the Affiliated Hospital of Guizhou Medical University from January 1,2016 to December 31,2020,including gender,age,first consultation department,intensive care unit(ICU)hospitalization time,ventilator use time,main diagnosis,acute physiology and chronic health evaluationⅡ(APACHEⅡ)when transferred into and out of ICU,treatment results,whether to give mechanical ventilation,whether to use a non-invasive ventilator to assist breathing,whether to die in 24 hours,rescue times and success rate,etc.Changes in the above indicators during the 5 years were analyzed.Results In the past 5 years,our hospital has treated 2668 patients in the comprehensive ICU with severe neurological,severe circulation,and severe trauma as the main treatment area,including 1648 males and 1020 females;aged 6 months to 94 years old,the average age(53.49±19.03)years old.Neurosurgery(907 cases)was the most frequently diagnosed department,the top 3 diseases were cerebral hemorrhage(539 cases),septic shock(214 cases),and hypovolemic shock(200 cases);ICU hospitalization time was 126(52,253)hours,ventilator time was 65(17,145)hours,APACHEⅡscores were 23.29±8.12 and 12.99±6.37 when transferred into and out of ICU.The proportion of receiving mechanical ventilation was 92.94%(2147/2310),and 314 cases used non-invasive ventilators.84 cases died within 24 hours(mortality was 3.15%).A total of 2585 rescues were performed,and the rescue success rate was 92.84%(2400/2585).From 2016 to 2020,the 5-year cure rates were 65.92%,65.83%,61.53%,65.64%,69.06%,respectively,and the 5-year mortality were 13.13%,14.29%,18.89%,16.69%,13.38%,respectively.Conclusions With the cont

关 键 词：重症医学 亚专科 运行状况分析 学科建设 

分 类 号：R197.323[医药卫生—卫生事业管理]