消化科整合医学模式对消化性溃疡合并大出血救治效果的影响

Impact of integrated medical model in the Gastroenterology Dept. on the treatment effect of peptic ulcer with massive hemorrhage

目的观察消化科整合医学模式对消化性溃疡合并大出血患者救治效果的影响。方法自2007年7月起,我院将消化内科、消化外科整合为一个一级临床科室,即消化科,建立完善的多学科一体化治疗的消化科整合医学模式。将接受消化科整合医疗模式治疗的121例消化性溃疡合并大出血患者作为治疗组,接受传统常规治疗的112例消化性溃疡合并大出血患者作为对照组,两组治疗药物的选择、内镜下治疗方式、手术方式的选择等方面的差异无统计学意义。比较两组患者的病死率、并发症发生率、外科手术率、术前平均住院日、平均住院日、医疗费用,并进行统计分析。结果经比较,治疗组患者的病死率、并发症发生率、外科手术率、术前平均住院日、平均住院时间、平均医疗费用等均明显低于对照组,差异有统计学意义(P<0.05)。结论消化科整合医学模式能降低并发症发生率和病死率,缩短住院时间,减少医疗费用等,具有一定的可行性及优越性。

Objective The paper aims to observe the impact of integrated medical model in the Gastroenterology Dept. on the treatment effect of peptic ulcer with massive hemorrhage. Method Since July, 2007, the hospital has integrated digestive system department and digestive surgery department into a class-1 clinical department -- Gastroenterology Dept. -- and established a complete medical model for multi-discipline integrated treatment. 121 patients of peptic ulcer with massive hemorrhage receiving treatment under the integrated medical model in the Gastroenterology Dept. were taken as the treatment group, and 112 patients of peptic ulcer with massive hemorrhage receiving conventional treatment were regarded as the control group; the differences of both groups in the selections of drug, endoscopic therapy method, and operation method were not statistically signifcant. Comparisons and statistical analysis were carried out on the fatality rates, complication incidence rates, surgical operation rates, average days of hospitalization before operation, average days of hospitalization, and medical expenses of patients in the two groups. Result It was revealed by comparisons that the fatality rate, complication incidence rate, surgical operation rates, average days of hospitalization before operation, average days of hospitalization, and average medical expenses of patients in the treatment group were all obviously lower than those of the control group, and the differences had statistical significance （P 〈 0.05）. Conclusion The integrated medical model in the Gastroenterology Dept. can reduce fatality rate and complication incidence rate, shorten hospitalization time, and decrease medical expenses, so it has certain feasibility and superiority.