發(fā)布時間：2018-05-09 19:46

  本文選題：肺炎 + 不明原因肺炎��； 參考：《安徽醫(yī)科大學》2017年碩士論文

【摘要】：目的為了解阜陽市不明原因肺炎網(wǎng)報狀況,進而對阜陽市傳染病醫(yī)院不明原因肺炎網(wǎng)報狀況進行調(diào)查,以期能夠發(fā)現(xiàn)網(wǎng)報狀況存在的問題及原因。并通過評估不明原因肺炎病例在臨床醫(yī)療機構(gòu)中的報告過程,以獲得病例定義修改的更進一步證據(jù),提高監(jiān)測系統(tǒng)發(fā)現(xiàn)新發(fā)急性呼吸道傳染病病例的敏感性和特異性,該項目的研究結(jié)果還將為修訂我國不明原因肺炎監(jiān)測方案提供一定依據(jù),以提高該系統(tǒng)發(fā)現(xiàn)新發(fā)急性呼吸道傳染病的能力。方法收集2016年02月29日-2016年05月10日期間在阜陽市傳染病醫(yī)院住院并診斷為不明原因肺炎125例患者的臨床和相關(guān)資料以及網(wǎng)報信息進行調(diào)查與分析。制定問卷調(diào)查,調(diào)查員借助醫(yī)院HIS信息網(wǎng)絡查詢系統(tǒng)每天對各科室入院病例進行鎖定查詢,發(fā)現(xiàn)診斷中包含有“肺炎”的病例,則按照國家衛(wèi)計委設計的問卷調(diào)表的要求,通過查閱病歷資料信息、對患者進行訪談、對接診管床醫(yī)師進行訪談和對上級醫(yī)師進行訪談等多途徑獲取患者的詳實信息,逐項填寫問卷。結(jié)果調(diào)查期間對入院診斷包含有“肺炎”診斷1176例患者的臨床資料進行初初步篩查,結(jié)果經(jīng)判斷符合不明原因肺炎病例定義數(shù)的為125例(10.63%),不明原因肺炎病例中男性71例,占56.80%;女性54例,占43.20%,男女比例為1.3:1;以兒童和老年人為主;職業(yè)大多為農(nóng)民、家務以及離退休人員。125例不明原因肺炎中采集到咽拭子標本數(shù)為110例(88%),咽拭子陽性例數(shù)為15例(13.63%),6例檢驗結(jié)果為甲型H1N1流感患者,9例為乙型流感患者,其中只有1例通過網(wǎng)絡系統(tǒng)進行了上報。調(diào)查未進行網(wǎng)報的原因:一些臨床醫(yī)生不了解不明原因肺炎監(jiān)測系統(tǒng)的有63例(50.81%),其中認為不符合不明原因肺炎病例定義者的57例(45.97%),認為住院時間短影響判斷的4例(3.22%)。結(jié)論為做好新發(fā)急性呼吸道傳染病防控工作,應進一步完善不明原因肺炎網(wǎng)報系統(tǒng),方便及時上報,并提高醫(yī)護人員對不明原因肺炎的重視程度,使不明原因肺炎監(jiān)測系統(tǒng)能夠達到工作常態(tài)化,做到及時上報,以免引起重大公共衛(wèi)生事件。
[Abstract]:Objective to investigate the situation of unknown cause pneumonia in Fuyang City and to find out the problems and causes of the network report of unknown cause pneumonia in the infectious disease hospital of Fuyang city. In order to obtain further evidence of the revision of the case definition, and to improve the sensitivity and specificity of the surveillance system for the detection of new cases of acute respiratory infectious diseases, the process of reporting cases of pneumonia of unknown origin in clinical medical institutions was evaluated in order to obtain further evidence of the revision of the case definition. The research results of the project will also provide some basis for revising the surveillance program of unidentified pneumonia in China, so as to improve the ability of the system to detect new acute respiratory infections. Methods from February 29, 2016 to May 10, 2016, 125 patients who were hospitalized in Fuyang Infectious Disease Hospital and diagnosed as unexplained pneumonia were investigated and analyzed. With the help of the hospital HIS information network inquiry system, investigators made a questionnaire survey every day to lock out the admission cases of various departments and departments, and found that the diagnosis included cases of "pneumonia," according to the requirements of the questionnaire table designed by the State Health and Family Planning Commission. The detailed information of the patients was obtained by consulting the medical records, interviewing the patients, interviewing the doctors in the receiving and managing beds, and interviewing the superior doctors, and filling out the questionnaires one by one. Results during the investigation period, the clinical data of 1176 patients diagnosed with "pneumonia" in hospital were initially screened. The results showed that the total number of cases of unexplained pneumonia was 10.63%, and 71 cases of unexplained pneumonia were male. 56.80; 54 women, 43.20, with a ratio of 1.3: 1; mainly children and the elderly; most of them are farmers, The number of pharynx swabs collected from household and retired persons with unexplained pneumonia was 110 cases and 88 cases, and the positive cases of throat swabs were 15 cases (13.63%) and 6 cases. The results showed that 9 cases of influenza A (H1N1) patients were type B flu patients. Only one case was reported through a network system. The reasons for not being reported online: some clinicians did not know about the surveillance system of unexplained pneumonia in 63 cases (50.81%), among which 57 cases (45.97%) thought that they did not meet the definition of unexplained pneumonia cases, and 4 cases (3.22%) thought that the short hospital stay had an effect on judgment. Conclusion in order to prevent and control new acute respiratory infectious diseases, we should further improve the network reporting system of unexplained pneumonia, facilitate timely reporting, and enhance the attention of medical staff to unknown cause pneumonia. The surveillance system of unknown pneumonia can be regular and timely reported so as to avoid causing major public health events.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R563.1

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