Under the background of a series of national policies, various forms of medical association have been established in recent years. The purpose of the medical association is to promote the coordination and integration of medical services and the rational distribution of medical resources. However, the implementation effect varies greatly. In the process of construction, there are problems such as the unsynchronized coordination and operation between the upper and lower levels, the inadequate integration of resources, the differences and conflicts in information standards and even cultural concepts, which limit the construction effect of the medical association to a certain extent. In order to solve these problems and explore a better path for the construction of medical association, this paper summarizes and analyzes the integrated development and construction measures of “discipline+operation” of the First People’s Hospital of Ziyang under the “government-hospital cooperation”, hoping to provide experience and reference for the construction of medical association to a certain extent through the summary and analysis, thus contributing to the better development of the construction of medical association.
Objective To investigate the clinical value on application of endoscopic parathyroiddectomy by gasless unilateral axillary approach, and perioperation management of patients. Methods Twenty-four patients with primary hyperparathyroidism were enrolled and were divided into open group (14 patients underwent open parathyroid surgery) and lumpectomy group (10 patients underwent endoscopic thyroidectomy by gasless unilateral axillary approach) according to the surgical method. All patients received the “5A” model management. The indexes related with perioperative conditions, postoperative incisional pain, and anterior cervical function were compared between the two groups. Results In the open group, 1 patient suffered from transient hoarseness after operation, 5 patients suffered from hypocalcemia on the first day after operation, and 6 patients suffered from temporary hypoparathyroidism. In the lumpectomy group, hypocalcemia occurred in 3 cases and temporary hypoparathyroidism occurred in 3 cases. There were no incision hematoma and infection cases occurred. There was no significant difference between the two groups in the incidence of hypocalcemia and the incidence of temporary hypoparathyroidism after operation (P>0.05). There was no case of incisional hematoma and infection, incisional pain, coughing and sputum excretion or painful swallowing with pain ≥3 in either group. The swallowing disorder index on postoperative day 3 and at 6 months, the scar assessment score and cosmetic satisfaction score at 6 months were higher in the open group than those in the lumpectomy group (P<0.05). Conclusion Patients underwent parathyroidectomy by gasless unilateral axillary approach have the advantages of good cosmetic results and preservation of the function of the anterior cervical region while safely removing the lesion.
Standardize day surgery can significantly improve hospital medical efficiency, reduce medical costs, and enhance patient satisfaction. In response to the difficulties and operational “bottlenecks” in day surgical management, Zhengzhou Central Hospital affiliated to Zhengzhou University has developed a suitable “centralized management and decentralized admission” day surgical model by referring to and combining existing domestic and foreign day surgical admission models. This article provides a detailed introduction to the management architecture, running process, and extended services of this management model, providing ideas for optimizing the day surgical diagnosis and treatment process and improving medical service efficiency.