远程医疗在新疆包虫病防诊治体系中的临床应用与分析

Clinical Application and Analysis of Telemedicine in the Prevention, Diagnosis and Treatment System of Echinococcosis in Xinjiang

目的通过对2 560例包虫病远程会诊病例分析,探讨基于远程医疗的区域包虫病防治新模式。方法对我院2009年1月至2013年12月的包虫病远程会诊病例进行分析,统计会诊人次、会诊疾病地方差异、会诊疾病谱特点及会诊上转率和住院费用节省情况。结果 1.会诊量呈逐年上升趋势,从2009年的182例,递增至2013年的873例,绝对增长量约5倍。2.北疆地区会诊量所占比例均在83%-91%之间,明显高于南疆地区和东疆地区。3. 会诊病例仍以肝包虫为主(99.42%),依次为肺包虫(0.24%)、盆腔包虫(0.19%)、脑包虫(0.12%)及心脏包虫(0.03%)。4.会诊上转率约为7.97%,92.03%的包虫病患者实现了属地诊疗,近5年为新疆地区包虫病患者总住院费用节约1 478万元,平均每例节约6 272元。结论包虫病远程医疗防诊治三级网络体系的构建和应用,有效地提升了基层医院包虫病防控能力,从一定程度上减轻了包虫病患者经济负担,创新了包虫病防控技术推广新模式,为探索区域包虫病防治的长效机制开辟了新路径。

Purpose To discuss about the new model of prevention and control of regional echinococcosis based on the telemedicine through the analysis of 2,560 remote consultation cases of echinococcosis. Method The remote consultation cases of echinococcosis in our hospital from January 2009 to December 2013 are analyzed. Statistics are carried on the person-time of consultation, local differences of disease consulted, characteristics of disease consulted, consultation transfer rate and savings of hospitalization expenses. Results 1. The consultation increases year by year. It increased from 182 cases in 2009 to 873 cases in 2013. The absolute growth is about 5 times. 2. The percentage of consultation in northern Xinjiang is 83%-91%, which is significantly higher than that in the southern Xinjiang and eastern Xinjiang. 3. The consultation case is still mainly liver hydatid （99.42%）, followed by pulmonary hydatid （0.24%）, pelvic hydatid （0.19%）, cerebral hydatid （0.12%） and cardiac hydatid （0.03%）. 4. The consultation transfer rate is about 7.97%. 92.03% of echinococcosis patients achieved diagnosis and treatment in the local place. In the last five years, the total hospitalization costs of echinococcosis patients in Xinjiang region was about RMB14.78 million. The average savings each case was about RMB6,272. Consultation The construction and application of prevention, diagnosis and treatment network system of echinococcosis telemedicine effectively improves the echinococcosis prevention and control ability of basic-level hospitals, reduces the economic burden of echinococcosis patients from a certain extent, innovates the promotion model of echinococcosis prevention and control technology, and opens up a new path for the exploration of long-term mechanism of regional echinococcosis prevention and control.