ObjectiveTo discuss the present situation of emergency physicians' communicational ability and the intervention measures. MethodsWe investigated 66 students who participated in continuing medical education of "emergency physicians' communication skills training course" from 2010 to 2013. All students accepted systematic training. After the training, we did the investigation again, and then made a comparison before and after the training. ResultsA major 78.8% of the students in this training had never taken part in the training of communication skills before; 51.5% of the students thought that the improvement of communication ability could be achieved mainly through long-term accumulation of clinical experiences. Students' self-evaluation showed that communication problem occurred 2 times a year in 10.6% of them, 3 times in 22.7%, 4 times in 24.2%, and five or more times in 34.8%. Students' role playing score in the scenario training rose from 5.374±0.686 to 6.717±0.517 after the training, and the difference was statistically significant (P=0.024). ConclusionEmergency physicians lack knowledge of communication skills which needs to be improved. Through training, the skills can be improved significantly.
目的 探讨血清降钙素原（PCT）、C反应蛋白（CRP）与急性生理及慢性健康评分标准Ⅱ（APACHE Ⅱ）评分在转诊肺炎合并脓毒症患者诊断中的相关性，以寻找更为简洁、快速判断其病情严重程度的指标。 方法 2009年1月－2010年12月，选取178例转诊肺炎合并脓毒症患者并进行脓毒症分级，对其进行血清PCT和CRP测定，并与APACHE Ⅱ评分及预后进行相关性分析。 结果 严重脓毒症组及脓毒性休克组患者血清PCT、CRP水平与APACHE Ⅱ评分较全身炎症反应综合征组及脓毒症组高（P＜0.05）；30 d内死亡的患者其血清PCT、CRP水平及APACHEⅡ评分较存活组明显增高（P＜0.05）；转诊肺炎合并脓毒症患者血清PCT与APACHE Ⅱ评分呈正相关（r=0.683，P=0.023），与血清CRP水平呈较弱的正相关（r=0.272，P=0.037）。 结论 对转院肺炎合并脓毒症患者进行血清PCT和CRP测定，对病情评估具有一定临床价值，特别是PCT可作为对转诊肺炎合并脓毒症患者病情程度判断的重要指标，为早期干预及治疗提供依据，值得临床推广应用。