目的 了解我院住院患者抗菌药物的临床应用现状及存在问题，为临床合理使用抗菌药物提供参考。 方法 采用回顾性调查方法，对本院2008年11月-2009年4月的出院病历资料进行统计、分析。 结果 共调查病历1 000份，抗菌药物总使用率58.70％；其中预防用药使用率62.35％，治疗用药使用率37.65％；联合用药的比例为37.31％；不合理用药占19.76%。 结论 抗菌药物使用率较高，且使用存在一些不合理现象。医院应加强监管，对存在的问题应制订相应措施。
ObjectiveTo compare the efficacy and compliance of children children with refractory epilepsy receiving ketogenic diet (KD) in outpatient department with children receiving KD treatment in inpatient department. MethodsA retrospective study of 44 children with intractable epilepsy receiving the modified classical ketogenic diets in outpatient department from June 2014 to December 2015, who were followed-up during the third, sixth and twelfth month. Records of epileptic seizures and adverse reactions were used to evaluate the efficacy and retention rate of inpatient department KD treatment in children with refractory epilepsy, and compared with 104 children receiving KD treatment in inpatient department at the same period. ResultsThirty-four of the forty-four children comleted observation after 12-month follow-up, 15 cases had been seizure freedom, 22 cases had more than 50% reduction in seizure frequency, 12 patients had less than 50% reduction in seizure frequency.The total effective rate of the KD therapy in outpatient department was 64.7%, and the retention rate was 71%. 18 of of the 104 children with KD treatment in inpatient department at the same period comleted observation after 12-month follow-up, 3 cases had been seizure freedom, 5 cases had more than 50% reduction in seizure frequency, 13 cases had less than 50% reduction in seizure frequency.The total effective rate of the KD therapy in inpatient department was 27.8%, and the retention rate was 17.3%. ConclusionThe KD therapy in outpatient department is effective to children with intractable epilepsy, and there is a highly efficacy and compliance of children receiving KD in outpatient department comparing with children receiving KD in inpatient department. Therefore, it's optional to children with refractory epilepsy who can't received KD by inpatient department because of insufficient number of beds.
ObjectiveTo analyze the effect of noninvasive positive pressure ventilation (NPPV) on the treatment of severe acute pancreatitis (SAP) combined with lung injury [acute lung injury (ALI)/acute respiratory distress syndrome (ARDS)] in emergency treatment. MethodsFifty-six patients with SAP combined with ALI/ARDS treated between January 2013 and March 2015 were included in our study. Twenty-eight patients who underwent NPPV were designated as the treatment group, while the other 28 patients who did not undergo NPPV were regarded as the control group. Then, we observed patients' blood gas indexes before and three days after treatment. The hospital stay and mortality rate of the two groups were also compared. ResultsBefore treatment, there were no significant differences between the two groups in terms of pH value and arterial partial pressure of oxygen (PaO2) (P>0.05). Three days after treatment, blood pH value of the treatment group and the control group was 7.41±0.07 and 7.34±0.04, respectively, with a significant difference (P＜0.05); the PaO2 value was respectively (60.60±5.11) and (48.40±3.57) mm Hg (1 mm Hg=0.133 kPa), also with a significant difference (P＜0.05). The hospital stay of the treatment group and the control group was (18.22±3.07) and (23.47±3.55) days with a significant difference (P＜0.05); and the six-month mortality was 17% and 32% in the two groups without any significant difference (P>0.05). ConclusionIt is effective to treat patients with severe acute pancreatitis combined with acute lung injury in emergency by noninvasive positive pressure ventilation.
Objective To investigate inpatients disease constitution, costs and rational drug use in the Karamay Central Hospital in 2014 and provide baseline data for further evidence-based study. Methods The information of disease classification, single disease drug use and expenditure of inpatients in 2014 were collected from the Hospital Information System (HIS) of Karamay Central Hospital. We classified the diseases according to the international classification of diseases coding (ICD-10), and analyzed the data by Microsoft Excel 2007 software including frequency, proportion, cumulative proportion and sample average. Results ① A total of 24 936 inpatients in 2014 were included, with male to female ratio being 0.96 to 1 and minority rate being 22.95%. The top three systematic diseases were respiratory diseases, diseases concerning pregnancy, child birth and puerperium and circulatory system diseases respectively; ② The top three age groups were 25 to 59, ≥60 and 0 to 4 respectively; ③ The top three costs per capita of single disease were pulmonary infectious, tumor chemotherapy and symptomatic treatment respectively; the top three western medicine costs per capita were tumor chemotherapy, symptomatic treatment and pulmonary infection; the top three Chinese medicine costs per capita were chronic kidney disease (CKD), angina and ischemic stroke. Conclusion The single diseases ranking and percentage of inpatients in 2014 of Karamay Central Hospital were different from the disease burden of Xinjiang Uygur Autonomous Region, the country and even the whole world. Based on the above results, the respiratory diseases and circulatory diseases were selected as the systematic evidence-based pharmacy study goal.
Object To investigate the constitution and expense of inpatient diseases in Jili Community Health Service Center (JCHSC) in Liuyang City of Hunan Province from 2008 to 2010, so as to provide baseline data for further study. Methods The questionnaire was applied and inpatient records in JCHSC between 2008 and 2010 were collected. The diseases were classified and standardized according to the International Classification of Disease, 10th Edition (ICD-10) based on the first diagnosis extracted from discharge records. Such information as general condition, discharge diagnosis and medical expenses etc. were analyzed by using statistic software of Microsoft Excel 2003 and SPSS 13.0. Results a) There were 9 chronic diseases and 6 acute ones among the top 15 single diseases, and both the average hospital stay and per-average hospitalization expense of chronic diseases were higher than those of acute ones (7.8 days vs. 5.6 days; ?2 733 vs. ?1551); b) Per-average expense of drugs as for both acute and chronic diseases accounted for nearly 50% of the total/general expense; c) There were 3 types of treatment models in JCHSC. Model A was only the internal medicine therapy, Model B was internal medicine assisted with surgery, and Model C was surgery assisted with internal medicine therapy; d) In detail, the total per-average expenses in JCHSC between 2008 to 2010 as for each single disease were as follows: coronary heart diseases (CHD, ?2 374 to ?2 680), urinary calculi (?3 268 to ?3 337), chronic bronchitis (?2 452 to ?2 488); e) Per-average hospitalization expenses in internal departments were ?1 719 to ?1 942 for acute diseases and ?2 386 and ?2 523 for chronic ones. Among surgical departments, the per-average hospitalization expenses as for acute diseases and chronic diseases were ?1 438 to ?1 579 and ?3 044 to ?3 607, respectively; and f) The average hospital stay for acute diseases in internal departments were 5.5 to 5.8 days for acute diseases and 6.9 to 7.3 days for chronic ones. By contrast, those in surgical departments were 5.9 to 6.2 days for acute diseases and 8.3 days for chronic ones, respectively. Conclusion a) In JCHSC, a total of 7 inpatient diseases among the top 15 single diseases in 2010 are all chronic with per-average total expense over ?2 000, which is higher than the average level of national CHSC (?2 357.6); b) According to the features of expense constitution models of the inpatient single diseases, the hospitalization expense should be controlled specifically; c) There are 3 kinds of diseases with yearly-increasing per-average total expenses as CHD, hypertension and pulmonary infection during recent 3 years; meanwhile, 4 diseases are with yearly-decreasing per-average total expenses as chronic bronchitis, cholecystolithias or accompanied with cholecystitis, diabetes and inguinal hernia; d) The per-average expenses of chronic diseases in surgical departments are higher than those in internal departments, but those of the acute diseases in surgical departments are lower. Meanwhile, the per-average total expenses as for both chronic and acute diseases in surgical departments present a decline trend year by year. Although the per-average expense on drugs as for both acute and chronic diseases in internal departments show a decline trend, the per-average total expenses indicate an ascending trend; and f) The average hospital stay of chronic diseases is longer than acute ones, while that of the surgical diseases is also longer than internal ones.
We summarize the primary structure, objective and achievements of the resident standard training program in West China Hospital of Sichuan University during the past decade. We also give some advices on how to develop and accomplish future goals of resident standard training.
Objective To investigate disease constitution of elderly inpatient in the Xuanwu Hospital, Capital Medical University in Beijing in 2011, so as to provide baseline data for further study. Methods Elderly (patients no less than 60 years old) inpatients’ records in the Xuanwu Hospital, Capital Medical University in 2011 were collected. Based on all the diagnosis on hospital discharge records, the diseases were standardized and classified according to the International Classification of Disease, 10th Edition (ICD-10). Data (including general information of the inpatients, all discharge diagnosis, and the distribution of disease type, age and sex) were analyzed through descriptive analysis using Microsoft Excel 2007 software. SPSS 17.0 software was performed for hypothesis test. Results a) The total numbers of elderly inpatients were 13 807 in 2011, accounting for 39.79% of all the inpatients. Males were more than females (male: female=1.26 to 1). The average kind of disease each patient was diagnosed with was 4.41, ranging from 1 to 11. b) The disease spectrum of patients with one disease was nervous system diseases, neoplasms, and digestive system diseases. The primary and secondary diseases of patients with two diseases were mostly circulatory system diseases. c) All the diagnosis included 18 categories, the top 7 were circulatory system diseases, endocrine, nutritional and metabolic diseases, digestive system diseases, respiratory system diseases, and nervous system diseases, accounting for 83.4% of all the diagnosis. The primary diagnosis included 18 categories, the top 5 were circulatory system diseases, neoplasms, digestive system diseases, respiratory system diseases, and nervous system diseases, accounting for 68.6% of all the elderly inpatients. d) In the circulatory system diseases, the top 5 diseases were cerebral infarction, occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction, angina pectoris, acute myocardial infarction, atherosclerosis, chronic ischaemic heart disease, accounting for 69.8% of all the circulatory system diseases patients. Diseases in different age and gender group were cerebral infarction, angina, acute myocardial infarction, and chronic ischemic heart disease (Plt;0.05). Conclusion The disease constitution of the Xuanwu Hospital, Capital Medical University is complex, and the primary diagnosis is mainly circulatory system diseases. It can be concluded that in the following studies attention should be paid to drug utilization of circulatory system diseases, so as to provide evidence for making the China specific potentially inappropriate medicine list and disease prevention for the elderly.
Objective To provide references to control the cost of stroke inpatients by analysing pertinent factors of stroke inpatients. Methods According to the models of Anderson and Newnan, univariable analysis and multivariable statistical analysis were applied to a number of factors including predisposing factors, enabling factors, and needs factors in 1 969 stroke inpatients of two third level first-class hospitals in Chongqing. Results Among the 1 969 stroke inpatients, 64% had a history of hypertension, and 50% exhibited hypertension during their stay in hospital. Expenditure on medication consumed the highest costs (51%). Length of stay was the most important factor affecting inpatient expense, additional factors were number of surgical operation, nurse type, Rankin score, number of complications etc. Conclusions Complex measures focusing on hypertension to prevent and control of stroke are recommended. Reducing unnecessary stay in hospital and appropriate prescribing are important methods to reduce cost of stroke inpatients.