中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2011年
3期
205-208
,共4页
朱卫国%王玉%方卫纲%陈嘉林%沙悦%黄晓明%黄程锦%曾学军%单渊东%沈悌
硃衛國%王玉%方衛綱%陳嘉林%沙悅%黃曉明%黃程錦%曾學軍%單淵東%瀋悌
주위국%왕옥%방위강%진가림%사열%황효명%황정금%증학군%단연동%침제
医院,综合%普通内科%疾病构成
醫院,綜閤%普通內科%疾病構成
의원,종합%보통내과%질병구성
Hospitals,general%General internal medicine%Spectrum of diseases
目的 总结北京协和医院普通内科2004-2008年收治住院患者的构成特点,初步探讨普通内科在大型综合医院设置的必要性.方法 回顾性分析2004-2008年北京协和医院普通内科住院患者的资料(患者来源、入院诊断、出院诊断等).结果 期间普通内科住院患者共2593例,其中男1075例,女1518例,平均年龄45.1岁.入院时诊断不清者占64.9%(1683/2593),其中不明原因发热(FUO)758例,非FUO待查病例925例.FUO最终明确诊断率89.2%(676/758),疾病前3位是肌肉骨骼系统和结缔组织疾病226例(29.8%)、传染病和寄生虫病199例(26.3%)、肿瘤110例(14.5%).非FUO的待查病例最终明确诊断率86.8%(803/925),疾病前3位为肌肉骨骼系统和结缔组织疾病230例(24.9%)、肿瘤143例(15.5%)、血液及造血系统疾病105例(11.4%).出院诊断共涉及550个病种.结论 北京协和医院普通内科住院患者具有来源广、疾病种类多、诊断不清比例高等特点.普通内科既解决了诊断不清等患者的收治问题,又为年轻医(学)生提供了良好的医学教育平台,体现了大型综合医院设置普通内科的必要性.
目的 總結北京協和醫院普通內科2004-2008年收治住院患者的構成特點,初步探討普通內科在大型綜閤醫院設置的必要性.方法 迴顧性分析2004-2008年北京協和醫院普通內科住院患者的資料(患者來源、入院診斷、齣院診斷等).結果 期間普通內科住院患者共2593例,其中男1075例,女1518例,平均年齡45.1歲.入院時診斷不清者佔64.9%(1683/2593),其中不明原因髮熱(FUO)758例,非FUO待查病例925例.FUO最終明確診斷率89.2%(676/758),疾病前3位是肌肉骨骼繫統和結締組織疾病226例(29.8%)、傳染病和寄生蟲病199例(26.3%)、腫瘤110例(14.5%).非FUO的待查病例最終明確診斷率86.8%(803/925),疾病前3位為肌肉骨骼繫統和結締組織疾病230例(24.9%)、腫瘤143例(15.5%)、血液及造血繫統疾病105例(11.4%).齣院診斷共涉及550箇病種.結論 北京協和醫院普通內科住院患者具有來源廣、疾病種類多、診斷不清比例高等特點.普通內科既解決瞭診斷不清等患者的收治問題,又為年輕醫(學)生提供瞭良好的醫學教育平檯,體現瞭大型綜閤醫院設置普通內科的必要性.
목적 총결북경협화의원보통내과2004-2008년수치주원환자적구성특점,초보탐토보통내과재대형종합의원설치적필요성.방법 회고성분석2004-2008년북경협화의원보통내과주원환자적자료(환자래원、입원진단、출원진단등).결과 기간보통내과주원환자공2593례,기중남1075례,녀1518례,평균년령45.1세.입원시진단불청자점64.9%(1683/2593),기중불명원인발열(FUO)758례,비FUO대사병례925례.FUO최종명학진단솔89.2%(676/758),질병전3위시기육골격계통화결체조직질병226례(29.8%)、전염병화기생충병199례(26.3%)、종류110례(14.5%).비FUO적대사병례최종명학진단솔86.8%(803/925),질병전3위위기육골격계통화결체조직질병230례(24.9%)、종류143례(15.5%)、혈액급조혈계통질병105례(11.4%).출원진단공섭급550개병충.결론 북경협화의원보통내과주원환자구유래원엄、질병충류다、진단불청비례고등특점.보통내과기해결료진단불청등환자적수치문제,우위년경의(학)생제공료량호적의학교육평태,체현료대형종합의원설치보통내과적필요성.
Objective To analyze the disease spectrum of patients admitted to the General Internal Medicine Unit at Peking Union Medical College Hospital, which is the first academic division of general internal medicine in the department of medicine within Chinese medical colleges and universities, and the value of general internal medicine unit in comprehensive hospitals. Methods A retrospective data review of patients admitted to the General Internal Medicine Unit from 2004 to 2008 was conducted from hospital information system and partially by chart review manually. Analysis of disease spectrum was performed thereafter. Results A total of 2593 patients were included in our study. It consisted of 1075 men and 1518women, with an average age of 45.1 years old. Forty point three percent of these patients were from Beijing,the local city, and the remaining 59.7% were from outside of Beijing. Sixty-four point nine percent (1683/2593)of these patients did not have a clear diagnosis on admission, including 758 fever of unknown origin (FUO) cases and 925 non-FUO cases. The final diagnostic rate of the FUO cases was 89. 2% [676/758, with the first three leading causes as diseases of the musculoskeletal system and connective tissue (29. 8%), certain infectious and parasitic diseases(26.3%), and neoplasm (14. 5%)] . The final diagnostic rate of the 928 non-FUO cases was 86. 8%(803/925), with the first three leading causes as musculoskeletal system and connective tissue(24.9%), neoplasm (15.5%), and diseases of blood and blood-forming organs(11.4%). Despite most diagnoses fitting into the above categories, the array of diseases was broad with as many as 550 discharge diagnoses from 2004 to 2008. Conclusions During 2004 -2008, there was a high proportion of cases that presented to the General Internal Medicine Unit at Peking Union Medical College Hospital with an unclear diagnosis, and the spectrum of diseases diagnosed was very broad. This kind of patient admitting model might not only benefit patients with no clear admission diagnosis and patients with multidisciplinary medical problems for whom it is usually difficult to be admitted by a specialty unit, but would also benefit medical students and residents by providing a good clinical medicine teaching base. These features show the value of general internal unit in comprehensive hospitals.
