消化科整合医学模式对急性上消化道大出血救治效果的影响

摘要

Objective To observe the effect of integrated medical model in Department of Digestion on medi-cal treatment of acute upper gastrointestinal hemorrhage. Methods A total of 168 patients of acute upper gastrointesti-nal hemorrhage from January 2000 to June 2007 who received traditional treatment were enrolled as control group, and 182 patients from July 2007 to June 2014 treated with integrated medical model were assigned as treatment group, by in-tegrating digestive internal medicine and digestive surgery into one unit (Digestive Department) and establishing a multi-disciplinary and integrated treatment mode. The two groups were compared in rescue success rate, mortality, inci-dence of complications, average length of hospital stay before operation, the average total length of hospital stay, medical costs to evaluate the therapeutic effect of two groups. Results Rescue success rate, mortality were 96.15％ and 6.04％ in the treatment group, versus 89.29％ and 13.69％ in the control group (P<0.05). The incidence of complications, average length of hospital stay before operation, average length of hospital stay, average medical cost were 26.37％, (3.32±2.21) d, (11.29±3.08) d, (9645.32±1230.45) Yuan in the treatment group, significantly lower than 38.10％, (5.67±2.45) d, (18.35±5.42) d, (12357.69±1670.62) Yuan in the control group (P<0.05). Conclusion Integrated medical model in Digestive Depart-ment can improve the rescue success rate, reduce the incidence of complications and mortality, shorten the total length of hospital stay and the length of hospital stay before operation, reduce medical costs, and significantly improve the progno-sis of patients, with feasibility and superiority.%目的 观察消化科整合医学模式对急性上消化道大出血救治效果的影响.方法 选取2000年1月至2007年6月在南宁市第三人民医院接受传统常规治疗的168例急性上消化道大出血患者作为对照组,2007年7月至2014年6月接受消化科整合医疗模式(将消化内科、消化外科整合为一个一级临床科室-消化科,建立完善的多学科一体化治疗的消化科整合医学模式)治疗的182例急性上消化道大出血患者作为观察组,比较两组患者的抢救成功率、死亡率、并发症发生率、术前平均住院日、平均住院日和医疗费用.结果 观察组患者的抢救成功率、死亡率分别为96.15％和6.04％,对照组分别为89.29％和13.69％,两组比较差异均有统计学意义(P<0.05);观察组患者的并发症发生率为26.37％、术前平均住院日(3.32±2.21)d、平均住院时间(11.29±3.08)d、平均医疗费用(9645.32±1230.45)元明显低于对照组的38.10％、(5.67±2.45)d、(18.35±5.42)d、(12357.69±1670.62)元,差异均有统计学意义(P<0.05).结论 消化科整合医学模式能提高患者抢救成功率,降低并发症发生率和死亡率,缩短住院时间和术前平均住院日,减少医疗费用,具有可行性及优越性.