基层医院利用网络医疗诊治肝胆急症的应用效果(1)
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[摘要] 目的 结合网络会诊监护系统使用体会，讨论基层医院利用网络医疗服务在肝胆急症中的应用价值。方法 70例肝胆急症患者通过网络急会诊78次，持续监护治疗3例；35例患者通过传统途径会诊；8例患者转诊至省级医院。结果 网络会诊组专家会诊意见与本院会诊处理意见完全一致的11例，经专家会诊改进本院处理方案的59例，其中3例患者本来认为几乎没有抢救价值的，经会诊及持续监护治疗抢救成功。网络医疗开展前后比较，会诊效率提高，会诊费用下降，危重患者抢救成功率提高。结论 借助网络医疗技术可提高基层医院对肝胆急症诊治水平，减少医疗纠纷，值得进一步推广。
[关键词] 网络医疗；会诊；监护；肝胆急症
[中图分类号] R197.32 [文献标识码] B [文章编号] 1673-9701(2011)20-138-03
Practice of Hepatic Emergency Medical Treatment Draw Support from Network in Basic Hospital
WU Weilin1XU Weidong1ZHANG Min2
1.Department of Hepatobiliary Surgery，People’s Hospital of Kecheng District in Quzhou City of Zhejiang Province，Quzhou 324000，China；2.Department of Hepatobiliary Surgery，The First Affiliated Hospital of Zhejiang University Medical School，Hangzhou 310009，China
[Abstract] Objective To combine network consultation monitoring system using experience， discuss basic-level hospital medical services using the network application value in treating emergency.Methods 70 cases of patients with acute liver 78 times through network urgent consultation，continuous monitoring treatment 3 cases. 35 patients through the traditional way consultation；8 patients referral to provincial hospital. Results The network consultation group opinions and our specialists agree consultation processing by 11 cases，have improved our specialists scheme of the 59 patients，3 patients had almost no salvage value that，after consultation and continuous monitoring treatment rescue success. Network medical conduct before-and-after， consultation improving efficiency， consultation fee drops， critically ill patient rescue success rate increase. Conclusion Using network medical technique may improve basic-level hospital emergency treatment level of courage，reduce the medical dispute，deserves further promotion.
[Key words] Network medical；Consultation；Guardianship；Treating acute
网络医疗服务平台主要是借助于宽带网络和电脑系统，患者在基层医院就诊检查，将呼吸、心跳、血压和血液、影像等相关检查的数据很快通过计算机传送，显示在省级医院医生的电脑屏幕上[1]。省级医院的专家可以实时了解患者的床边监测、病情变化等情况，及时制订相应的治疗和抢救措施[2]。我院自2008年3月与浙医一院建立网络医疗服务平台，通过该平台进行远程会诊、持续监护治疗以及远程教学和查房，2008年3月～2010年6月使用网络平台对70例肝胆急症患者进行诊断和治疗，评价其临床应用价值，现报道如下。
1资料与方法
1.1一般资料
网络会诊与监护组：肝胆急症病例70例，男39例，女31例；年龄19～82岁，平均年龄56岁；疾病种类：肝内外胆管结石11例，急性腹膜炎9例，急性胆管炎4例，急性胰腺炎8例，肿瘤性疾病16例、肝切除手术后感染2例、急性肾功能不全2例 ......
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