国内神经内科住院总医师临床会诊文献回顾分析

Retrospective analysis of the clinical consultation by a neurology chief resident in the department of neurology

目的总结国内神经内科会诊科室的分布特点及会诊疾病谱的构成,为科室医师临床与科研培训提供借鉴意义。方法通过检索国内文献数据库,检索2005-09—2015-09已发表关于神经内科会诊病例分析的报道,进行文献回顾性分析。结果共纳入研究报道7篇,会诊病例总数4 899例,男2 334例(47.6%),女2 565例(52.4%),年龄5个月~101岁。常规会诊3114例(63.32%),急会诊1 804例(36.68%)。会诊科室以内科最多。急会诊以急性脑血管病、昏迷!意识障碍、癫痫发作等常见,常规会诊以头晕!眩晕、头痛、陈旧性脑血管病、周围神经病变、精神障碍性相关疾病常见。结论会诊中应明辨神经系统疾病的症状及种类,详尽询问病史及体格检查,及时调整自身知识结构,掌握疾病谱系的演变,以辨证哲学思维指导临床医学发展。

Objective To investigate the distribution and characteristics of consultation cases about department of Nephrology,to analyze the composition of the disease spectrum, and to provide the reference for clinical, scientific research and training. Methods Electronic databases from Sept. 2005 to Sept. 2015 about retrospective analysis of the cases consulted by a neurology chief resident were collected and the literature review and analysis. Results A total of 7 studies including 4 899 participants,which fulfilled the inclusion criteria were considered for analysis, the age of inpatients who received neurology consultation ranged from 5 months to 101 years old. 2 334 males（47.6%） and 2 565 women（52.4%） were consulted,including regular consultation in 3 114 cases（63.32 % ）, urgent consultation in 1 804 cases （36.68 % ）. The major consultation cases were from medical department. The most common diagnosis for routine consultation was dizzy or vertigo, old cerebrovascular disease, peripheral neuropathy, mental diseases and related disorders,and acute cerebrovascular,coma/consciousness disorder,epilepsy were the most common disorders for emergency consultation. Conclusion Strengthen and identify the symptoms and signs of nervous system diseases,a careful and detailed medical history and physical examination,timely adjust the professional structure, update the professional knowledge and the evolution of the clinical spectrum of disease,and improve clinical diagnosis thinking.