门诊肾功能异常患者各科室分布情况及转诊率调查

Investigation on the distribution and referral rate of patients with abnormal renal function in outpatient departments

目的了解三甲医院门诊肾功能异常患者临床科室分布及转诊情况,以提高其早期转诊率,达到早诊断、早治疗的目的。方法收集2018全年在苏州大学附属第一医院门诊就诊的所有实验室检查提示肌酐超过正常值上限的非透析非移植患者的资料,根据就诊日期明确患者第一次就诊科室及日后的就诊科室,明确患者是否前往肾内科专科门诊就诊,并计算患者转诊率。结果肾功能异常患者广泛分布于各临床科室,肾内科占比仅25.99%,且中年男性占比最高。肾内科及非肾内科就诊患者肾功能分期较一致,均尚处于疾病早中期。患者总体转诊率仅3.46%,就诊人数较多科室中,保健体检中心转诊率最低,仅1.29%。结论肾功能异常患者广泛分布于临床科室,但患者转诊率低,因此应加强肾内科医务人员对相关知识的宣传与普及;加强各科室之间的交流,提高其对肾脏病的重视程度及对早期肾脏病的警惕性,及时发现早期肾脏损害,及时转诊,提高肾脏病早期诊断率及患者转诊率,使患者得到有效的治疗与管理。

Objective To understand the distribution and referral rate of patients with abnormal renal function in outpatient departments in a Third-grade class-A hospital,so as to improve the early referral rate and achieve early diagnosis and treatment.Methods The clinical data of patients whose serum creatinine was above the upper limit of the normal range(without transplant and dialysis)in the First Affiliated Hospital of Soochow University in 2018 were collected.According to the date of visit,the department of first visit and later visit of the patients were identified,in order to determine whether the patients visited Department of Nephrology and calculate the transfer rate.Results The patients with abnormal renal function were distributed in different clinical departments widely.The proportion of patients visited Department of Nephrology was only 25.99%,and middle-aged men accounted for the highest proportion.There was substantial agreement regarding renal function staging between patients in Department of Nephrology and those in other departments,all in the early and middle stage.The overall referral rate of patients was only 3.46%.Among the departments with many visits,the referral rate in health examination center was the lowest,only 1.29%.Conclusion Patients with abnormal renal function were widely distributed in different clinical departments,but the transfer rate of patients was low.Therefore,medical staff of Department of Nephrology should strengthen the publicity and popularization of relevant knowledge.It is also recommended to strengthen the communication between medical staff of different departments and improve their attention to renal disease and vigilance to early renal disease,so that they could find early renal damage and referral timely to facilitate earlier diagnosis of renal disease and improve referral rate,to provide valid management and effective treatment for patients.