健康体检重要异常结果分级管理实践的回顾分析

Review and Analysis of Grading Management Practice of Important Abnormal Results in Physical Examination

目的了解健康体检重要异常结果中的主要健康问题,为健康体检重要异常结果分级管理提供依据。方法回顾性分析2018年度在作者医院体检中心完成健康体检的4321例资料,分类统计重要异常结果并进行统计学分析。结果(1)4321例受检者中重要异常结果共792例(18.33%),其中男性511例,年龄14~83(45.72±14.42)岁;女性281例,年龄20~81(45.80±14.21)岁;(2)前3位异常结果分别为肥胖、肺结节和甲状腺结节;女性甲状腺结节、乳腺结节检出率高于男性,差异有显著统计学意义(χ^(2)值分别为32.85,56.70,P均<0.01);(3)可疑糖尿病男性检出率高于女性,差异有统计学意义(χ^(2)=4.99,P<0.05);(4)肥胖、血脂异常、肝功能异常男性检出率高于女性,差异有显著统计学意义(χ^(2)值分别为34.94,14.58,7.43,P均<0.01);(5)在重要异常结果中,Ⅰ级重要异常结果18例(2.27%),Ⅱ级重要异常结果221例(27.90%),Ⅲ级异常结果553例(69.82%),Ⅲ级重要异常结果检出率显著高于Ⅰ级、Ⅱ级重要异常结果,差异有显著统计学意义(χ^(2)值分别为783.82,278.48,P均<0.01);(6)重要异常结果通知情况:电话通知到本人及家属353人(44.57%),取报告时通知本人及家属217人(27.40%),通知负责人转告受检者189人(23.86%),未留联系方式致无法通知者33人(4.17%)。结论作者科室对"重要异常结果"管理方法进行了完善改进,提升了健康体检服务质量及水平,提高了受检者对异常结果的重视及受检者的体检满意度。

Objective To understand the main health problems in the important abnormal results of the health examination,and to provide the basis for grading management of the important abnormal results in the health examination.Methods A total of 4321 patients who completed physical examination in author′s hospital in 2018 were retrospectively analyzed,the important abnormal results were classified and analyzed.Results(1)The results of 792(18.33%)subjects were significant abnormal among the 4321 subjects,including 511 males,aged 14~83(45.72±14.42)years old,and 281 female patients,aged 20~81(45.80±14.21)years old.(2)The first 3 abnormal results were obesity,pulmonary nodules and thyroid nodules,respectively;the detection rate of thyroid nodules and breast nodules of females were higher than those of males(χ^(2)value was 32.85,56.70,respectively,P<0.01).(3)The detection rate of suspected diabetes of males was higher than that of females(χ^(2)=4.99,P<0.05).(4)The detection rate of obesity,dyslipidemia and abnormal liver function of males were higher than those of females(χ^(2) value was 34.94,14.58,7.43,respectively,all P<0.01).(5)In the important abnormal results,levelⅠwas 18 cases(2.27%),levelⅡwas 221 cases(27.90%),levelⅢwas 553 cases(69.82%),the detection rate of levelⅢwas significantly higher than that of levelⅠ,Ⅱ(χ^(2 )value was 783.82,278.48,respectively,all P<0.01).(6)Notification of the important abnormal results:353 people(44.57%)were notified by telephone,217 people(27.40%)were notified when receiving the report,189 people(23.86%)were informed by the person in charge,and 33 people(4.17%)were lost follow-up.Conclusion Author′s department has been improved the management method of"important abnormal results",improved the quality and level of physical examination service,and also promoted the attention to abnormal results and the satisfaction of the examination.