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大型三级医院中心急诊神经内科会诊分析:住院医师规范化培训效果随访。

Analysis of urgent inpatient neurologic consultations in a large tertiary hospital center: Follow-up on the effect of standardized training of residents.

机构信息

Department of Neurology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Department of Neurology, Affiliated Hospital of Chongqing Three Gorges Medical College, Chongqing, China.

出版信息

Brain Behav. 2023 May;13(5):e2983. doi: 10.1002/brb3.2983. Epub 2023 Mar 27.

Abstract

BACKGROUND

Clinical neurology is difficult for young residents. To familiarize with neurological emergencies as soon as possible for young doctors, the urgent inpatient neurologic consultations were analyzed.

METHODS

A retrospective study was conducted on the urgent inpatient neurologic consultations in a large tertiary hospital for 4 consecutive years.

RESULTS

A total of 1437 cases were included, and the annual consultation cases gradually decreased from 573 to 257, involving 29 clinical departments. The disorders of urgent inpatient neurologic consultations were divided into three categories: neurological disorders (77.8%), non-neurological disorders (10.4%), and undiagnosed disorders (11.8%), common causes in consultation were disturbance of consciousness (36.0%), convulsions/stiffness (13.6%), limb weakness (8%), and mental disorder (5.6%). Common neurological disorders included acute cerebrovascular disease (33.6%), epilepsy/status epilepticus (15.8%), and metabolic or infectious toxic encephalopathy (14.9%).

CONCLUSION

Urgent inpatient neurologic consultations involve multidisciplinary critical diseases, mainly neurological diseases. The standardized training of residents may help to rapidly improve the comprehensive diagnosis and treatment ability of young residents and is suitable for use in hospitals at all levels.

摘要

背景

临床神经病学对年轻住院医师来说具有一定难度。为使年轻医生尽快熟悉神经科急症,对大型三级医院连续 4 年的急会诊进行了分析。

方法

对某大型三级医院连续 4 年的急会诊进行回顾性研究。

结果

共纳入 1437 例,年度会诊例数从 573 例逐渐减少至 257 例,涉及 29 个临床科室。急会诊患者的疾病分为 3 类:神经系统疾病(77.8%)、非神经系统疾病(10.4%)和未明确诊断疾病(11.8%),会诊常见病因依次为意识障碍(36.0%)、抽搐/僵硬(13.6%)、肢体无力(8%)和精神障碍(5.6%)。常见的神经系统疾病包括急性脑血管病(33.6%)、癫痫/癫痫持续状态(15.8%)和代谢或感染性中毒性脑病(14.9%)。

结论

急会诊涉及多学科急危重症,以神经系统疾病为主。对住院医师进行规范化培训可能有助于迅速提高年轻住院医师的综合诊治能力,适合各级医院开展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8b0/10176006/e2e74f5574e9/BRB3-13-e2983-g001.jpg

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