江苏省ICU现况调查分析

A questionnaire survey of present situation of ICU in Jiangsu province

目的调查分析江苏省有关加强医疗病房(ICU)资源及学科建设问题,并提出建议。方法2005年3月至2005年9月,通过问卷方式调查江苏省二、三级医院ICU基本情况。结果61家医院共有各类ICU 180个,其中综合性ICU 56个,专科ICU 124个；专科ICU平均拥有数为三级医院(3．47±1．63)个,二级医院(0．65±0．80)个。采用封闭式管理模式的占60．66%。三级医院综合性ICU床位占医院总床位的1．15%±0．31%,二级医院为1．94%±0．76%。ICU医生数与床位之比三级医院为(0．74±0．28)：1；二级医院为(0．66±0．25)：1。护士数与床位数之比三级医院(1．65±0．56)：1；二级医院(1．56±0．50)：1。颅内压监测、脑电双频指数监测、主动脉球囊反搏开展率较低。面临的主要问题是工作压力大、待遇低、收治范围不明确、患者来源受限等。结论江苏省ICU发展迅速,已初具规模,但在技术项目上仍有较大发展空间。建议重视综合ICU建设,制定ICU建设管理规范及质控标准,加强人才培养,确定准入制度,进一步发挥ICU在危重病医学中的作用。

Objective To investigate the distribution of intensive care unit （ICU） resource and disciplinary construction in Jiangsu province, and to put forward a proposal to the solution of existed problems. Methods Two hundred ten written questionnaire were sent to the municipal and county hospitals in Jiangsu province from March to September 2005. Results One hundred eighty ICU in 61 hospitals responded, including 56 general ICU and 124 special ICU. There were on average 3.47 ± 1.63 special ICUs in municipal hospitals and 0.65 ± 0.80 special ICUs in county hospitals, and 60.66% general ICUs were founded before 2000 and 60.66% ICUs run mainly by ICUs specialist. ICUs beds occupied 1.15% ± 0.31% of total beds in municipal hospitals and 1.94% ± 0.76% in county hospitals. The ratio of physician to ICUs beds was （0.74 ± 0.28） ：1 in municipal hospitals and （0.66 ± 0.25） ：1 in county hospitals, at the same time, the ratio of nursesto ICUs beds was （1.65 ± 0.56） ： 1 and （1.56 ± 0.50） ： 1, respectively. All ICUs were equipped with electrocardiograph monitor （ECG）, pulse oximetry, ventilator, defibrillator and so on . Devices of continuous noninvasive blood pressure （NIBP）, central venous pressure （CVP） monitoring, blood gas analysis, endotracheal tubes as well as noninvasive ventilator were available in most hospitals. Only a few hospitals could monitor intracranial pressure （ICP） and bispectral index （BIS）, and could insert intra-aortic balloon pump （IABP）. The main problems in ICUs were the staff bearing heavy work burden and stress with getting disproportionately low pay, the limited patients resources and construction of ICUs team and so on. Conclusion This survey shows that ICUs in Jiangsu province has fast developed to a certain extent, but there is a large space to improve in the technical field. At present, a standard of medical service in ICUs should be made to ensure a good management and efficient operation. To found an emergency-ICUs system and develop the training program of ICUs staff are essential important.