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目的通过对临床医师进行肺栓塞专业知识培训,对比分析培训前后不同专业医师对肺栓塞患者的诊断状况。方法 2005-01在华北油田医疗集团所属医院进行肺栓塞专业知识讲座,制定肺栓塞诊治流程,分别收集宣教前后全院肺栓塞患者收治科室分布、首诊确诊、误诊状况及肺栓塞知识问卷调查。结果宣教前后肺栓塞确诊人数分别为58例及106例,宣教前后主要发病科室由骨科、普通外科转为呼吸内科、心内科,首诊确诊率前后为34.5%、57.5%,误诊率25.9%、10.4%,宣教前主要诊断科室为心内科、呼吸内科,宣教后为呼吸内科、急诊科、心内科、肿瘤内科。培训后问卷调查得分较培训前显著上升。结论通过肺栓塞专业知识培训可以有效地减少误诊的发生,提高临床医师诊断意识,增加首诊确诊率。
Objective To compare the diagnosis of pulmonary embolism before and after the training by different physicians before and after the training of clinicians on the professional knowledge of pulmonary embolism. Methods From January 2005 to January 2005, a lecture on pulmonary embolism was conducted at the hospital affiliated to Huabei Oilfield Medical Group. The process of diagnosis and treatment of pulmonary embolism was established. The distribution of departmental diagnosis, diagnosis and misdiagnosis of the patients with pulmonary embolism and the questionnaire of knowledge of pulmonary embolism were collected before and after the mission. Results The number of pulmonary embolism cases before and after the mission was 58 cases and 106 cases respectively. Before and after the mission, the main department of pathogenesis changed from orthopedics and general surgery to respiratory medicine and cardiology. Before and after the first diagnosis, the diagnosis rate was 34.5% and 57.5% respectively, the misdiagnosis rate was 25.9% 10.4%. The main diagnostic departments before the mission were cardiology and respiratory medicine, and post-mission respiratory medicine, emergency department, cardiology and oncology. After the training, the questionnaire score increased significantly compared with that before the training. Conclusions The training of PE knowledge can effectively reduce the incidence of misdiagnosis, improve clinicians’ awareness of diagnosis and increase the diagnosis rate of first diagnosis.