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背景:NICE关于处理儿童头颅损伤的指南出版于2003年6月。他们的建议与先前皇家医院外科医生联盟(RCS)出版的指南明显不同。提倡用计算机断层摄影术(CT)代替头颅X线检查和自我陈述。在英国,这些指南对于提供医疗服务的影响还不确切。方法:在英格兰西北部三所医院收集有不同程度头颅损伤儿童的所有临床资料,确定头颅X线检查、CT扫描以及自我陈述的比例。如果按照RCS或NICE的指南,头颅X线检查、CT扫描以及自我陈述的比例是可以确定的。结果:对三所医院在2000年2月至2002年8月间收住的10965 例患者的资料进行研究发现:进行头颅X线检查的患者为25%,接受CT检查的患者为0.9%,3.7%的患者为仅做自我陈述。严格按照RCS指南其结果分别为,进行X线检查者占50%,CT扫描者占1.6%,自我陈述者占7.1%,按照NICE指南其结果分别为0.3%,8.7%, 1.4%。但是如果应用呕吐3次或更多次的标准代替超过1次即进行CT检查,那么CT检查率将下降6.3%。结论:按照新的NICE指南,不会因头颅损伤患者就诊造成工作量增加,而只是将对患者的处理从观察病房转
Background: NICE’s guide to dealing with head injury in children was published in June 2003. Their advice differs significantly from the guidelines published by the Royal Hospital Surgeon Union (RCS). To promote the use of computed tomography (CT) instead of skull X-ray examination and self-statement. In the UK, the impact of these guidelines on the delivery of health care is not yet clear. METHODS: All clinical data on children with varying degrees of head injury were collected at three hospitals in northwestern England to determine the proportion of head X-rays, CT scans, and self-statements. If you follow the guidelines of RCS or NICE, the proportions of skull X-ray examination, CT scan and self-statement can be determined. RESULTS: Data from 10 965 patients admitted to the three hospitals between February 2000 and August 2002 were analyzed: 25% of patients underwent head X-ray examination, 0.9% of patients underwent CT examination, and 3.7% % Of patients are self-statements only. In strict accordance with the RCS guidelines, the results were 50% for X-ray examinations, 1.6% for CT scanners and 7.1% for self-statements, with 0.3%, 8.7% and 1.4% of the NICE guidelines, respectively. However, if the standard of vomiting three or more times is used instead of more than one time for a CT scan, the CT examination rate will decrease by 6.3%. CONCLUSIONS: According to the new NICE guidelines, there is no increase in workload due to head injury visits, only the shift from observation ward to patient treatment