上海20家医院住院患者静脉血栓栓塞症防治效果回顾性研究  

Retrospective Study on the Prevention and Treatment Effect of Venous Thromboembolism among Inpatients in 20 Hospitals in Shanghai

作　　者：黄晓燕[1,2] 周帅 侯冷晨 许媛媛 尚寒冰 陈尔真 吴宏[2,6] 瞿介明 陆勇[1,2] HUANG Xiaoyan;ZHOU Shuai;HOU Lengchen(Luwan Branch,Ruijin Hospital,School of Medicine,Shanghai Jiaotong University Shanghai,Shanghai,200020,China)

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院,上海200020 [2]上海市肺栓塞和深静脉血栓防治联盟,上海200020 [3]上海交通大学医学院附属瑞金医院,上海200025 [4]上海申康医院发展中心,上海200041 [5]上海市医院协会,上海200040 [6]上海市卫生健康委员会,上海200125

出　　处：《中国卫生质量管理》2022年第12期38-42,共5页Chinese Health Quality Management

基　　金：上海市医院协会医院管理研究基金项目——上海市医疗机构院内VTE防治现状及影响因素的SEM研究(编号:X2022143);基于人工智能辅助诊断的区域多中心VTE规范防治效果比较研究(编号:Q2022063);上海市卫生健康委2022年卫生健康政策研究课题(编号:2022HP64);协同医疗健康基金会VTE防治科研基金项目——医联体模式下区域性VTE规范防治效果评价研究(编号:P089)。

摘　　要：目的 了解上海市级三级综合医院静脉血栓栓塞症(VTE)防治效果,为提高医院内VTE防治管理水平提供参考。方法 回顾性分析2019年-2020年上海申康医院发展中心单病种数据库中20家市级三级综合医院VTE防治相关数据,同时实地调研其VTE防治能力。结果 2020年,上海20家市级三级综合医院VTE发生率为1.00%,比2019年上升14.94%(χ^(2)=115.26,P<0.001);住院患者VTE风险评估率和出血风险评估率分别为71.06%、25.96%,比2019年分别上升16.13%(χ^(2)=28 754.00,P<0.001)、53.25%(χ^(2)=2 167.74,P<0.001);住院VTE风险患者所有预防措施实施率为34.12%,比2019年上升33.02%(χ^(2)=22 790.00,P<0.001);医院相关性VTE死亡率为5.35%,比2019年下降21.55%(χ^(2)=3.91,P<0.05)。超过2/3的医院建立了较完整的VTE管理体系,并开展了相关学科建设。结论 上海市级三级综合医院住院患者VTE规范防治能力有一定提升,但也存在较大改进空间。延伸VTE防治关口,建立全周期风险评估流程;多学科协作,构建VTE综合防治体系;加强培训与宣教,提高VTE规范预防率;提高诊疗技术水平,降低VTE相关死亡率等,是医院提高VTE防治管理水平的工作重点。Objective To investigate the prevention and treatment effect of Venous Thromboembolism(VTE) in Shanghai municipal tertiary general hospitals, and to provide reference for improving the prevention and management level of VTE in hospitals. Methods The data related to VTE prevention and treatment in 20 municipal tertiary general hospitals from the single disease database of Development Center of Shanghai Shenkang Hospital from 2019 to 2020 were retrospectively collected, and field research was performed on VTE prevention and control capacity. Results In 2020, the incidence of VTE in 20 municipal tertiary general hospitals in Shanghai was 1.00%, which was 14.94% higher than that in 2019(χ^(2)=115.26, P<0.001). The VTE risk assessment rate and bleeding risk assessment rate of inpatients were 71.06% and 25.96%, respectively, which increased by 16.13%(χ^(2)=28 754.00, P<0.001) and 53.25%(χ^(2)=2 167.74, P<0.001) compared with those in 2019. The implementation rate of all preventive measures among inpatients at risk of VTE was 34.12%, which was 33.02% higher than that in 2019(χ^(2)=22 790.00, P<0.001). The mortality rate of hospital-associated VTE was 5.35%, which was 21.55% lower than that in 2019(χ^(2)=3.91, P<0.05). More than 2/3 of hospitals had established a relatively complete VTE management system and carried out the construction of related disciplines. Conclusion The standard prevention and treatment ability of VTE among inpatients in Shanghai tertiary general hospitals had been improved to a certain extent, but there was still a large room for improvement. Extending the VTE prevention and control gateways and establishing the full-cycle risk assessment process;multi-disciplinary cooperation to build an integrated VTE prevention and treatment system;strengthen training and education to improve the standard prevention rate of VTE;improve the technical level of diagnosis and treatment and reduce the mortality of VTE will be the focus of the hospital to improve the prevention and management level of VTE.

关 键 词：三级综合医院 住院患者 静脉血栓栓塞症 防治效果 回顾性分析 

分 类 号：R197.323[医药卫生—卫生事业管理]