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目的分析四川大学华西医院内分泌代谢科总住院医师院内和院际会诊病例构成情况,总结会诊内分泌代谢专科疾病在其他各专业科室的分布特点,以有助于总住院医师日常工作优化安排和内分泌代谢专科医师培养。方法纳入2012年7月1日—2013年6月30日由内分泌代谢科总住院医师完成的1 299份会诊病例,回顾性分析会诊申请科室分布、病例的构成及分布特点。总结会诊的内分泌代谢疾病谱特点并比较不同科室对内分泌代谢会诊的需求差异。结果 1 299例会诊病例中,男612例(47.11%),女687例(52.89%);年龄14~96岁,中位年龄56.3岁;院际会诊747例(57.51%),院内会诊552例(42.49%)。急会诊患者请会诊理由以糖尿病合并手术、外伤后应激性血糖升高为主,其次是甲状腺疾病及电解质紊乱等问题。申请会诊的科室以急诊科为主,会诊目的主要为血糖控制。外科和妇科会诊主要目的是合并糖尿病、甲状腺疾病等内分泌代谢疾病的患者围手术期评估及治疗调整,产科会诊目的主要为甲状腺功能亢进症合并妊娠、妊娠糖尿病的治疗和围手术期血糖的控制。结论临床会诊工作存在诸多挑战,为总住院医师学习和巩固专业知识及积累临床经验提供了良好的机会。总住院医师应了解会诊病例的构成及分布特点,尽可能为日常工作进行优化安排,在临床会诊中不断总结经验,提高自身诊疗水平。
Objective To analyze the composition of inpatient and inpatient consultations in the department of endocrinology and metabolism in West China Hospital of Sichuan University and to summarize the distribution characteristics of the specialties of endocrine and metabolic diseases in other specialties in the department of general surgery so as to be helpful for the general arrangement and endocrine metabolism Specialist training. Methods A total of 1 299 consultation cases completed by the Chief Physician, Department of Endocrinology and Metabolism, from July 1, 2012 to June 30, 2013, were retrospectively analyzed. The distribution of cases, the composition and distribution of cases were retrospectively analyzed. Summary of consultation endocrine and metabolic disease spectrum characteristics and compare different departments of endocrine and metabolic consultation needs differences. Results Among 1 299 cases, 612 (47.11%) were male and 687 (52.89%) were female. The age ranged from 14 to 96 years, with a median age of 56.3 years. There were 747 cases (57.51%) in inter-hospital consultation and 552 cases in hospital (42.49%). Consult the patient urgently consultation reason to diabetic surgery, traumatic stress-induced hyperglycemia, followed by thyroid disease and electrolyte disorders and other issues. The department applying for consultation is mainly emergency department, and the main purpose of consultation is blood glucose control. Surgical and gynecological consultation is the main purpose of the merger of patients with endocrine and metabolic diseases such as diabetes, thyroid disease, perioperative evaluation and treatment adjustment, obstetric consultation mainly for hyperthyroidism with pregnancy, gestational diabetes and perioperative blood glucose control. Conclusion There are many challenges in clinical consultation, which provide a good opportunity for residency to learn and consolidate professional knowledge and accumulate clinical experience. Resident physicians should understand the composition and distribution characteristics of consultation cases, optimize the daily work as much as possible, continuously summarize experience in clinical consultation and improve their own diagnosis and treatment.