综合三甲医院骨科院内会诊分析及其对临床与教学的指导意义  

Analysis of consultation in orthopedic department of comprehensive grade A hospital and its guiding significance to clinic and teaching

作　　者：刘森[1] 王炜[1] 袁堂谧 仉建国[1] 杨波[1] LIU Sen;WANG Wei;YUAN Tang-mi;ZHANG Jian-guo;YANG Bo(Department of Orthopedics,Peking Union Medical College Hospital,CAMS&PUMC,Beijing 100730,China;Department of Anesthesiology,Peking Union Medical College Hospital,CAMS&PUMC,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院骨科,北京100730 [2]中国医学科学院,北京协和医学院,北京协和医院麻醉科,北京100730

出　　处：《基础医学与临床》2022年第12期1968-1972,共5页Basic and Clinical Medicine

基　　金：北京协和医学院研究生教改项目(PUMC-GS-2015005);北京协和医学院本科生教改项目(2015zlgc0122)。

摘　　要：目的分析大型综合三甲医院骨科接收院内提请的普通会诊的时间、空间分布规律、疾病谱以及对骨科医师的专业技术要求,以加强临床教学并提高会诊质量及效率。方法通过医院信息系统采集整理北京协和医院2020年12月至2022年1月骨科接收的普通会诊数据,对会诊的发送时间、发送科室、会诊目的、涉及疾病、骨科处理意见、会诊与患者主要住院目的之间的关系进行分类总结。结果统计时间内,骨科共完成院内普通会诊1528例次,涉及41个临床科室,周一较其他工作日发送量大,每天上午8时~11时、下午15时~17时为会诊发送高峰;申请骨科会诊最多的为神经内科,主要会诊疾病为退行性疾病;另有大量激素应用相关的骨科疾病。约1/3的会诊与主要住院目的无直接关系。会诊病例中约2/3需要骨科进行不同程度干预,另有1/3准备工作不全或仅需口头指导即可。结论院内会诊工作量较大,在时间、申请科室等方面呈不均一分布。建议会诊医师在周一预留充足时间以保障会诊及时性。今后可在会诊医师上岗前加强退行性疾病、激素相关骨科疾病的培训,并尝试加强骨科常见疾病的基础教育以及毕业后教育。Objective To evaluate the time span,space distribution,disease spectrum,professional and technical requirements of orthopedic surgeons for consultation in orthopedic department in a large comprehensive grade A hospital,so as to strengthen clinical teaching and improve the quality and efficiency of consultation.Methods The data of consultation received by the department of orthopedics in Peking Union Medical College Hospital from December 2020 to January 2022 were collected and sorted out by the hospital information system,and the correlation between consultation time span,department,consultation purpose,diseases involved,orthopedic treatment opinions,relevance of consultation to patients'main purpose of hospitalization was classified and summarized.Results In the statistical time range,a total of 1528 consultations were completed by the department of orthopedics,involving 41 clinical departments.The consultation calling peak was from 8 am to 11 am and from 15 pm to 17 pm,and consultation on Monday was more than other days.The department of neurology submitted the most applications for orthopedic consultation,and the main diseases were degenerative diseases.There were also a large number of orthopedic disorders associated with hormone use.About 1/3 of the consultations were not directly related to the primary purpose of hospitalization.About 2/3 of the consultation cases required orthopedic intervention,while another 1/3 had incomplete preparation or only needed oral instruction.Conclusions The working load of in-hospital consultation can not be ignored.The time span and departments submitting the consultation application are unevenly distributed.The recommendation for consultants is to reserve sufficient time on Monday to ensure timely consultation.The consultation content mainly focuses on degenerative diseases and glucocorticoids related orthopedic diseases.In the future,the training of consulting physicians and the basic education as well as post-graduation education of common orthopedic diseases should be str

关 键 词：骨科 会诊 分析 临床教学 

分 类 号：R68[医药卫生—骨科学]