本文關(guān)鍵詞： 遠(yuǎn)程會診系統(tǒng) 重癥監(jiān)護(hù)病房 MODS　出處：《山東大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討通過遠(yuǎn)程會診系統(tǒng)指導(dǎo)治療方案對MODS患者臨床療效,為遠(yuǎn)程會診系統(tǒng)對MODS患者的應(yīng)用價(jià)值提供根據(jù)。材料和方法1.一般資料連續(xù)性選擇山東大學(xué)附屬省立醫(yī)院東院ICU病房中自2014年1月至2015年4月期間治療的MODS患者42例,其中使用常規(guī)治療方案的MODS患者31例,并組成常規(guī)方案組,本院使用遠(yuǎn)程會診系統(tǒng)指導(dǎo)治療方案的MODS患者11例,并組成遠(yuǎn)程會診組。并對患者進(jìn)行隨訪,隨訪時(shí)間為1月。2.方法2.1搜集上述患者在轉(zhuǎn)入ICU后住院時(shí)間、APACHEII評分、平均動(dòng)脈壓(MAP)血乳酸(Lac)、天冬氨酸氨基轉(zhuǎn)移酶(AST)、谷氨酸氨基轉(zhuǎn)移酶(ALT)、總膽紅素(TBIL)、尿素氮(BUN)、肌酐(Cr)水平、尿量、住院天數(shù)、病死率。2.2結(jié)合2.1中搜集到的資料,通過比較常規(guī)方案組與遠(yuǎn)程會診組患者WBC計(jì)數(shù),分析應(yīng)用遠(yuǎn)程會診系統(tǒng)指導(dǎo)治療方案對炎癥反應(yīng)的影響。2.3結(jié)合2.1中搜集到的資料,通過比較常規(guī)方案組與遠(yuǎn)程會診組患者BUN、Cr、尿量,分析應(yīng)用遠(yuǎn)程會診系統(tǒng)指導(dǎo)治療方案對患者腎功能的影響。2.4結(jié)合2.1中搜集到的資料,通過比較常規(guī)方案組與遠(yuǎn)程會診組患者AST、ALT、TBIL,分析應(yīng)用遠(yuǎn)程會診系統(tǒng)指導(dǎo)治療方案對患者肝功能的影響。2.5結(jié)合2.1中搜集到的資料,通過比較常規(guī)方案組與遠(yuǎn)程會診組患者M(jìn)AP、Lac分析應(yīng)用遠(yuǎn)程會診系統(tǒng)指導(dǎo)治療方案對患者血液灌注情況的影響。2.6結(jié)合2.1中搜集到的資料,通過比較常規(guī)方案組與遠(yuǎn)程會診組患者APACHE Ⅱ評分,分析應(yīng)用遠(yuǎn)程會診系統(tǒng)指導(dǎo)治療方案對整體療效的影響。2.7結(jié)合2.1中搜集到的資料,通過比較常規(guī)方案組與遠(yuǎn)程會診組患者住院天數(shù),分析應(yīng)用遠(yuǎn)程會診系統(tǒng)指導(dǎo)治療方案對住院時(shí)間的影響。2.8結(jié)合2.1中搜集到的資料,通過比較常規(guī)方案組與遠(yuǎn)程會診組患者28d病死率,分析應(yīng)用遠(yuǎn)程會診系統(tǒng)指導(dǎo)治療方案對患者28d生存率的影響。3.統(tǒng)計(jì)分析處理數(shù)據(jù)以均數(shù)±標(biāo)準(zhǔn)差(X±s)表示；采用SPSS 19統(tǒng)計(jì)分析軟件進(jìn)行統(tǒng)計(jì)分析。正態(tài)分布且方差齊樣本采用t檢驗(yàn),非正態(tài)分布樣本采用秩和檢驗(yàn),計(jì)數(shù)資料采用x2檢驗(yàn)及其校正公式。P值均取0.05為顯著性標(biāo)準(zhǔn)。結(jié)果通過應(yīng)用遠(yuǎn)程會診系統(tǒng),專家可以根據(jù)患者情況提出針對性的治療建議,優(yōu)化現(xiàn)有的治療方案,能有效提高治療效率,例如更合理的使用抗生素、更有效率的開展血液凈化治療等,使MODS患者能在更短的時(shí)間內(nèi)改善心、肺、肝、腎等的功能,再通過指導(dǎo)后續(xù)治療,使患者得到更完善的治療方案,從而減少患者的住院時(shí)間,并進(jìn)一步減少患者的病死率,達(dá)到預(yù)期的治療效果。結(jié)論1.應(yīng)用遠(yuǎn)程會診系統(tǒng)指導(dǎo)治療方案能有效改善MODS患者的臨床治療效果。2.通過遠(yuǎn)程會診系統(tǒng)指導(dǎo)治療方案可以減少M(fèi)ODS患者的住院時(shí)間。3.使用遠(yuǎn)程會診系統(tǒng)指導(dǎo)治療方案有效降低MODS患者28d的病死率。
[Abstract]:Objective: to explore the clinical efficacy of remote consultation system in guiding the treatment of MODS patients. Materials and methods for the application of remote consultation system to MODS patients. 1. General data continuity selection of 42 MODS patients who were treated from January 2014 to April 2015 in ICU ward of Eastern Hospital affiliated to Shandong University. Among them, 31 patients with MODS were treated with routine therapy, and 11 patients with MODS were treated by remote consultation system. The patients were followed up. Methods the follow-up time was from January to January. Methods the Apache II score, mean arterial pressure (map) blood lactate, aspartate aminotransferase (AST), glutamate aminotransferase (alt), total bilirubin (Tbilirubin), urea nitrogen (bun), creatinine (Cr), urine volume were collected after admission to ICU. Days of hospitalization, mortality. 2.2 combined with the data collected in 2.1. By comparing the WBC counts of patients in routine and remote consultation groups, the effects of remote consultation system on inflammatory response were analyzed. By comparing the amount of BUNC Cr, urine of patients in routine and remote consultation groups, we analyzed the effect of remote consultation system on renal function of patients. 2.4 and 2.1 data were collected. By comparing AST alt TBILs between routine and remote consultation groups, the effects of remote consultation system on liver function of patients were analyzed. 2.5 and 2.1 data were collected. The effects of remote consultation system on patients' blood perfusion were analyzed by comparing the data collected in the routine protocol group and remote consultation group. 2. 6 combined with 2. 1. 1. By comparing the APACHE 鈪，

本文編號：1533365