华中地区79家医院急诊脓毒症诊治现状调查分析

Investigation and analysis of the diagnosis and treatment status of sepsis in the emergency department of 79 hospitals in central China

目的:了解当前湖北省急诊脓毒症诊治现状及急诊医务人员对脓毒症的认知情况。方法:采用德尔菲法并依据脓毒症指南与专家共识自行设计的急诊脓毒症现状调查问卷,对华中地区共17个地级市、自治州或省直辖县级行政单位的79家医院急诊科150名医生的脓毒症诊治现状进行了调查。结果:急诊医务人员对中国预防脓毒症行动(PSCC)的知晓率仅有39.3%,脓毒症Hour-1 bundle的知晓率为53.3%。Hour-1 bundle中血培养依从性最低,仅有45.3%,大部分人认为不能实施的原因是急诊条件有限。急诊医务人员认为影响脓毒症诊治效果最主要的原因是早期识别能力有限,诊断不及时(34.0%),更愿意通过专家讲座来学习脓毒症的知识。结论:建议加强急诊脓毒症患者筛查、诊断与管理的培训,提高脓毒症患者早期识别率,通过对围脓毒症期患者的合理诊治,降低脓毒症的病死率。

Objective: To investigate the current status of diagnosis and treatment of sepsis in emergency department and the cognition of sepsis among emergency medical staff. Methods: A questionnaire was designed based on Delphi methods and the sepsis guidelines and expert consensus. One hundred and fifty emergency physicians in 79 hospitals of 17 prefecture-level cities, autonomous prefectures or county-level administrative units in central China participated in the survey. The main content of the survey was diagnosis and treatment status of sepsis patients in emergency department. Results: The awareness rate of emergency medical staff about preventing sepsis campaign in China(PSCC) was only 39.3%, and the awareness rate of sepsis hour-1 bundle was 53.3%. The blood culture compliance in the hour-1 bundle is the lowest, only 45.3%. Most people believe that the reason for the failure to implement is limited emergency conditions. Emergency medical staff believe that the main reason affecting the effectiveness of sepsis diagnosis and treatment is limited early recognition ability and delayed diagnosis(34.0%), and they are more willing to learn about sepsis through expert lectures. Conclusion: It is recommended to strengthen the training in the screening, diagnosis and management of emergency sepsis patients, improve the early recognition rate of patients with sepsis, and reduce the fatality rate of sepsis through reasonable diagnosis and treatment of patients with peri-sepsis.