医疗联合体区域医疗信息平台的设计与构建及其在腹主动脉瘤手术患者中的应用观察

Observation on the application of design and construction of regionally medical information platform on the basis of medical consortium in patients with abdominal aortic aneurysm

目的:基于医疗联合体设计构建区域医疗信息平台,研究其在腹主动脉瘤手术患者中的应用价值。方法:以面向服务的架构(SOA)为平台,使用可扩展标记语言(XML)、Web Services作为实现技术,结合并充分利用事件驱动架构(EDA)、云计算、浏览器与服务器(B/S)构架、可视化流程管理、业务行为监控以及实时访问等技术,设计构建区域医疗信息平台。选取医院收治的63例腹主动脉瘤行腔内隔绝手术(EVAR)患者,按平台应用时间,将2016年12月至2017年12月应用区域医疗信息平台前收治的34例患者纳入对照组,2018年1月至2018年12月应用区域医疗信息平台后收治的29例患者纳入观察组,采用调查表对比分析两组患者术后并发症发生情况、患者对医疗服务的满意度及疾病知识认知程度和焦虑抑郁情绪评价。结果:对照组术后并发症6例(占17.65%),观察组术后并发症1例(占3.49%),观察组并发症发生率低于对照组,两组比较差异有统计学意义(χ^2=6.571,P<0.05);观察组患者对医疗服务的满意度及护理知识认知程度评分均高于对照组,差异有统计学意义(t=7.112,t=6.753;P<0.05);观察组焦虑和抑郁情绪评分均低于对照组,差异有统计学意义(t=5.432,t=8.124;P<0.05)。结论:医疗联合体区域医疗信息平台应用于腹主动脉瘤EVAR患者,可提高医疗服务质量和效率,减少患者术后并发症的发生,提高患者对医疗服务的满意度及对疾病知识的认知程度。

Objective:To explore the application value of regionally medical information platform on the basis of design and construction of medical consortium in patients with abdominal aortic aneurysm.Methods:Service-Oriented Architecture(SOA)was used as the platform,and Extensible Markup Language(XML)and Web Services were used as implementation techniques,and Event Driven Architecture(EDA),cloud computing,browser and server(B/S)architecture,visual process management,business behavior monitoring and real-time access were combined and fully used to design and construct regionally medical information platform.A total of 63 patients with abdominal aortic aneurysm who underwent endovascular isolation surgery(EVAR)were selected from the hospital.According to the successive sequence of the time of design and construction of platform,the admitted 34 patients before the regionally medical information platform was constructed(from December 2016 to December 2017)were included in control group,and the admitted 29 patients after the regionally medical information platform was constructed(from January 2018 to December 2018)were included in observation group.And the incidences of postoperative complications,the satisfaction of patient for medical services,cognition degree of patients for disease knowledge,and the evaluations of anxiety and depression of patients between the two groups were compared and analyzed.Results:In control group,6 cases occurred postoperative complication(17.65%),and 1 case of observation group(3.49%)occurred postoperative complication.The incidence of complications in observation group was significantly lower than that in control group(χ^2=6.571,P<0.05).The satisfaction of patient for medical services and cognition degree of patients for nursing knowledge in observation group were significantly higher than those in control group(t=7.112,t=6.753,P<0.05),respectively.And the scores of anxiety and depression of observation group were significantly lower than those of control group(t=5.432,t=8.124,P<0.05),respectively.Conclusion:The regionally medical information platform on the basis of medical consortium,that is applied in patients with abdominal aortic aneurysm who undergo EVAR,can improve the quality and efficiency of medical services,and reduce the incidence of postoperative complications,and increase satisfaction of patients for medical service and cognition degree of patients for disease knowledge.