肿瘤专科医院院际会诊特点分析

Characteristics of Interhospital Consultation in Cancer Specialized Hospitals

目的分析肿瘤专科医院院际会诊的特点,探讨院际会诊对肿瘤专科医院患者诊疗方案的影响。方法回顾性分析北京大学肿瘤医院2013年1月1日至2017年12月31日期间肿瘤患者进行院际会诊的1323例病历资料,明确会诊原因、会诊目的及会诊结果,分析院际会诊对抗肿瘤方案制定产生的影响。结果 1 323例患者中急会诊:117例(8.8%),普通会诊:1 206例(91.2%)。受邀请会诊较多的专业科室是:心内科、神经内科和呼吸科。会诊的疾病包括:心血管疾病317例(24.0%)、呼吸系统疾病182例(13.8%)、血液系统疾病139例(10.5%)、神经系统病变132例(10.0%)、消化系统疾病131例(10.0%)、泌尿系统疾病82例(6.2%)、皮肤病及性病65例(4.9%)、内分泌与代谢性疾病53例(4.0%)、自身免疫性疾病23例(1.7%),其他疾病199例(15%)。通过院际会诊,894例患者(67.5%)获得最佳抗肿瘤治疗,350例患者(26.5%)获得最佳对症支持治疗,79例(6.0%)患者未能明显获益。住院期间的疾病转归:1 286例(97.2%)患者病情稳定或者好转,37例(2.8%)患者病情恶化死亡。结论心血管疾病是导致肿瘤专科医院院际会诊的主要原因。院际会诊有助于抗肿瘤治疗方案的制定。

Objective To analyze the characteristics of the interhospital consultation in cancer hospitals, and to discuss the influence of interhospital consultation on the diagnosis and treatment of the patients in cancer hospitals. Methods We retrospectively analyzed the consultation records and related clinical medical records of 1323 patients hospitalized in Peking University Cancer Hospital from January 1, 2013 to December 31, 2017. We made clear the reasons, the purpose and the results of the consultation. Results In the 1323 cases, urgent consultation： 117（8.8%） cases; general consultation： 1206（91.2%） cases. The top three departments invited were the Departments of Cardiology, Neurology and Respiration. The consultations included cardiovascular disease（317 cases, 24.0%）, respiratory disease（182 cases, 13.8%）, blood system disease（139 cases, 10.5%）, nervous system disease（132 cases, 10.0%）, digestive system disease（131 cases, 10.0%）, urinary system disease（82 cases, 6.2%）, skin disease and venereal disease（65 cases, 4.9%）, endocrine and metabolic diseases（53 cases, 4.0%）, autoimmune disease（23 cases, 1.7%） and other diseases（199 cases, 15.0%）. Treatment benefits from consultation： 894（67.5%） patients received the best antitumor treatment, 350（26.5%） patients received best supportive care, 79（6%） cases showed no significant benefit. Prognosis in hospital： 1286（97.2%） patients had stable or improved conditions, and 37（2.8%） patients had deteriorated diseases and died. Conclusion Cardiovascular disease is the leading cause of interhospital consultation in cancer specialized hospitals. Interhospital consultations are helpful to the formulation of antitumor treatment.