阜阳市传染病医院不明原因肺炎网报状况调查及成因分析

发布时间：2018-05-09 19:46

本文选题：肺炎 + 不明原因肺炎　；参考：《安徽医科大学》2017年硕士论文

【摘要】：目的为了解阜阳市不明原因肺炎网报状况,进而对阜阳市传染病医院不明原因肺炎网报状况进行调查,以期能够发现网报状况存在的问题及原因。并通过评估不明原因肺炎病例在临床医疗机构中的报告过程,以获得病例定义修改的更进一步证据,提高监测系统发现新发急性呼吸道传染病病例的敏感性和特异性,该项目的研究结果还将为修订我国不明原因肺炎监测方案提供一定依据,以提高该系统发现新发急性呼吸道传染病的能力。方法收集2016年02月29日-2016年05月10日期间在阜阳市传染病医院住院并诊断为不明原因肺炎125例患者的临床和相关资料以及网报信息进行调查与分析。制定问卷调查,调查员借助医院HIS信息网络查询系统每天对各科室入院病例进行锁定查询,发现诊断中包含有“肺炎”的病例,则按照国家卫计委设计的问卷调表的要求,通过查阅病历资料信息、对患者进行访谈、对接诊管床医师进行访谈和对上级医师进行访谈等多途径获取患者的详实信息,逐项填写问卷。结果调查期间对入院诊断包含有“肺炎”诊断1176例患者的临床资料进行初初步筛查,结果经判断符合不明原因肺炎病例定义数的为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%,男女比例为1.3:1;以儿童和老年人为主;职业大多为农民、家务以及离退休人员。125例不明原因肺炎中采集到咽拭子标本数为110例(88%),咽拭子阳性例数为15例(13.63%),6例检验结果为甲型H1N1流感患者,9例为乙型流感患者,其中只有1例通过网络系统进行了上报。调查未进行网报的原因:一些临床医生不了解不明原因肺炎监测系统的有63例(50.81%),其中认为不符合不明原因肺炎病例定义者的57例(45.97%),认为住院时间短影响判断的4例(3.22%)。结论为做好新发急性呼吸道传染病防控工作,应进一步完善不明原因肺炎网报系统,方便及时上报,并提高医护人员对不明原因肺炎的重视程度,使不明原因肺炎监测系统能够达到工作常态化,做到及时上报,以免引起重大公共卫生事件。
[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.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.1

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