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Diet and medical foods in Parkinson’s disease 被引量:3
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作者 Klaus W.Lange Yukiko Nakamura +4 位作者 Ning Chen Jianjun Guo Shigehiko Kanaya Katharina M.Lange Shiming Li 《Food Science and Human Wellness》 SCIE 2019年第2期83-95,共13页
Parkinson’s disease (PD) is a slowly progressive neurodegenerative disorder with motor and non-motorsigns, which begins long before the diagnosis can be made. Pharmacotherapy with dopaminergic drugsis the mainstay of... Parkinson’s disease (PD) is a slowly progressive neurodegenerative disorder with motor and non-motorsigns, which begins long before the diagnosis can be made. Pharmacotherapy with dopaminergic drugsis the mainstay of PD therapy. There is no currently available cure or disease-modifying treatment. Dietand various foods have been proposed as possible risk factors for PD. Nutritional supplementation withomega-3 fatty acids, vitamin D, B vitamins, and coenzyme Q may have potential in the management ofPD. In addition, several strategies could possibly lead to the development of medical foods in PD. Forexample, ketogenic diets may have effects complementary to pharmacotherapy. Gut microbial dysbiosisand altered microbial metabolites found in PD may lead to chronic low-grade inflammation in gut andbrain. Interventions targeting gut microbiota, such as the supplementation of probiotics, may providenovel approaches to PD in regard to both symptomatic treatment and disease modification. High qualityrandomized controlled trials need to be conducted in order to evaluate whether these food-basedstrategies have symptomatic efficacy or the potential to delay the progression of PD. 展开更多
关键词 parkinsons disease DIET medical food Ketogenic diet PROBIOTICs Prevention
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Parkinson’s Disease Detection Using Biogeography-Based Optimization 被引量:1
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作者 Somayeh Hessam Shaghayegh Vahdat +4 位作者 Irvan Masoudi Asl Mahnaz Kazemipoor Atefeh Aghaei Shahaboddin Shamshirband Timon Rabczuk 《Computers, Materials & Continua》 SCIE EI 2019年第7期11-26,共16页
In recent years,Parkinson’s Disease(PD)as a progressive syndrome of the nervous system has become highly prevalent worldwide.In this study,a novel hybrid technique established by integrating a Multi-layer Perceptron ... In recent years,Parkinson’s Disease(PD)as a progressive syndrome of the nervous system has become highly prevalent worldwide.In this study,a novel hybrid technique established by integrating a Multi-layer Perceptron Neural Network(MLP)with the Biogeography-based Optimization(BBO)to classify PD based on a series of biomedical voice measurements.BBO is employed to determine the optimal MLP parameters and boost prediction accuracy.The inputs comprised of 22 biomedical voice measurements.The proposed approach detects two PD statuses:0-disease status and 1-good control status.The performance of proposed methods compared with PSO,GA,ACO and ES method.The outcomes affirm that the MLP-BBO model exhibits higher precision and suitability for PD detection.The proposed diagnosis system as a type of speech algorithm detects early Parkinson’s symptoms,and consequently,it served as a promising new robust tool with excellent PD diagnosis performance. 展开更多
关键词 parkinsons disease(PD) biomedical voice measurements multi-layer perceptron neural network(MLP) biogeography-based optimization(BBO) medical diagnosis bio-inspired computation
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Palliative care for Parkinson’s disease patients and their caregivers
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作者 Zhao Wang Yue Wang +2 位作者 Zhang-Yi Wang Chao-Kai He Xiao-Li Pang 《Life Research》 2022年第1期20-24,共5页
Parkinson's disease is still incurable and the long-term care needs of patients represent a huge challenge for health systems.Palliative care as an alternative therapy can greatly alleviate the suffering and burde... Parkinson's disease is still incurable and the long-term care needs of patients represent a huge challenge for health systems.Palliative care as an alternative therapy can greatly alleviate the suffering and burden on patients and caregivers through effective medical symptom management,the provision of mental health support,and the development of health plans.This paper explores the current status and challenges regarding palliative care for patients with Parkinson's disease in recent years through a literature review approach.The findings can provide scientific evidence for researchers,clinical practitioners and policy makers in this field.We not only reviewed the systematic and effective therapy,but also concluded a new multidisciplinary cooperation model.TCM teams such as acupuncturists,TCM pharmacists and TCM physiotherapists should be key members of the new multidisciplinary team for the palliative care of Parkinson's disease. 展开更多
关键词 parkinsons disease palliative care hospice care disease management CAREGIVERs
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Evaluation of Clinical Utility of the Personal KinetiGraph<sup>&reg;</sup>in the Management 被引量:1
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作者 Fatta B. Nahab Hamad Abu-Hussain Lissette Moreno 《Advances in Parkinson's Disease》 2019年第3期42-61,共20页
INTRODUCTION: Parkinson’s disease (PD) is a disorder characterized by complex motor and non-motor symptoms that can be difficult for patients to accurately communicate. Wearable technologies portend improvements in a... INTRODUCTION: Parkinson’s disease (PD) is a disorder characterized by complex motor and non-motor symptoms that can be difficult for patients to accurately communicate. Wearable technologies portend improvements in assessment and monitoring of these symptoms, with their clinical utility currently being evaluated in routine clinical care. OBJECTIVE: To evaluate the clinical utility of the Personal KinetiGraph? (PKG?) Movement Recording System in the routine clinical care of persons with PD (PWP). METHODS: Clinically stable, non-demented PWP presented for two routine clinic visits that included: medication review, symptom review, neurological examination including the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) III/IV, and completion of a clinical management plan by a movement disorder specialist prior to review of the PKG report. After reviewing the PKG report, the clinician completed a modified clinical management plan taking into consideration the findings of the PKG. This was repeated at a second visit to evaluate various outcome measures following PKG-enhanced management. RESULTS: The PKG improved the assessment of PD symptoms and the response to treatment, while increasing patient activity levels and compliance. Clinical management plans enhanced by PKG led to different recommendations in 29.4% of cases compared with standard of care due to higher rates of bradykinesia, dyskinesia, tremor, and fluctuations identified by PKG. Using the PKG in the clinical management plan led to a change in medications in 75% (21/28) of patients and both a statistically significant difference and a clinically meaningful reduction in MDS-UPDRS III score of 4.8 (p = 0.028). Additionally, positive changes in both the clinician (17/28;61%) and patient-reported (13/24;54%) Global Impression of Improvement were reported. CONCLUSION: The PKG is a valuable tool in augmenting clinical management when utilized along with a clinical assessment. 展开更多
关键词 parkinsons disease WEARABLE Objective Measurement Clinical management
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规范化管理住院病案首页信息在DRGs准确分组中的应用价值 被引量:1
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作者 郁济 王晓颖 《国际医药卫生导报》 2023年第22期3250-3253,共4页
目的探讨规范化管理住院病案首页信息在疾病诊断相关分组(DRGs)准确分组中的应用价值。方法回顾性分析2022年1月至12月无锡市第二人民医院内科接受管理的132例病案,将采取传统常规DRGs管理的66例病案划分为对照组,其中男34例,女32例,年... 目的探讨规范化管理住院病案首页信息在疾病诊断相关分组(DRGs)准确分组中的应用价值。方法回顾性分析2022年1月至12月无锡市第二人民医院内科接受管理的132例病案,将采取传统常规DRGs管理的66例病案划分为对照组,其中男34例,女32例,年龄22~49(38.65±6.36)岁;采取规范化管理住院病案首页信息的66例病案划分为试验组,其中男35例,女31例,年龄21~48(38.23±6.25)岁。对比两组DRGs准确分组情况、医护人员满意度和DRGs分组差错率。统计学方法采用χ^(2)检验、t检验。结果试验组DRGs分组规范率高于对照组,病案返修率低于对照组[81.82%(54/66)比60.61%(40/66)、6.06%(4/66)比19.70%(13/66)],差异均有统计学意义(χ^(2)=7.246、5.469,均P<0.05)。试验组医护人员满意度评分高于对照组[(25.36±1.38)分比(20.21±1.14)分],差异有统计学意义(t=5.854,P<0.05)。试验组差错的总发生率低于对照组[4.55%(3/66)比18.18%(12/66)],差异有统计学意义(χ^(2)=6.092,P<0.05)。结论规范化管理住院病案首页信息应用于DRGs准确分组中,可提高病案质量与医护人员满意度,减少差错的总发生率,值得医疗机构推广应用。 展开更多
关键词 规范化管理 病案首页信息 疾病诊断相关分组 满意度 差错发生率
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Medication Side Effect Profiles in PD Patients in a Safety-Net Hospital
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作者 Daniella C. Sisniega Divya Madhusudhan +4 位作者 Elham Rahmani Robert McInnis Janice Weinberg Marie-Hélène Saint-Hilaire Anna DePold Hohler 《Advances in Parkinson's Disease》 2017年第4期101-112,共12页
Background: Compulsive behavior, dyskinesias, motor fluctuations, and hallucinations are common Parkinson’s disease (PD) medication side effects. These are yet to be examined in relation to race and level of educatio... Background: Compulsive behavior, dyskinesias, motor fluctuations, and hallucinations are common Parkinson’s disease (PD) medication side effects. These are yet to be examined in relation to race and level of education. The goal of this analysis was to identify socioeconomic or clinical variables that are associated with compulsive behavior, dyskinesias, motor fluctuations, and hallucinations in patients in a safety-net hospital. Methods: A movement disorder patient database containing 452 patients with idiopathic PD was analyzed for differences in PD medication side effects using univariate and multivariate logistic regression analysis. Race, sex, and level of education were evaluated as possible confounders. Results: A greater proportion of the patients in this study were Caucasian males. The only variable associated with compulsive behavior was age, with higher age having a protective effect (p = 0.0336). Disease duration (defined as time since the onset of symptoms), diagnosis duration (time since formal diagnosis), and level of education were significantly associated with dyskinesia inunivariate analysis (p =< 0.0001, <0.0001, 0.1236 respectively). However, diagnosis duration was the only variable significantly associated with dyskinesia in multivariate analysis (p = 0.0038), in addition to a borderline significant association when comparing individuals with graduate degree to those who had completed high school education or less (p = 0.0599), with a protective effect of higher education. Disease duration, diagnosis duration, and use of monoamineoxidase inhibitors were also significantly associated with motor fluctuations in the univariate analysis, while only diagnosis duration was significantly associated with motor fluctuations in multivariate analysis (p = 0.0035) with longer diagnosis duration associated with higher risk of motor fluctuations. Age, disease duration, and diagnosis duration were associated with an increased risk of hallucinations in univariate analysis (p =< 0.0001, <0.0001, <0.0001 respectively), but age and disease duration were the only variables associated with hallucinations in multivariate analysis (p = 0.0009, 0.1196 respectively). Race was not associated with a higher risk of compulsive behavior, dyskinesias, motor fluctuations, or hallucinations. Conclusion: Compulsive behavior, dyskinesias, motor fluctuations, and hallucinations in our PD population may be associated with differences in socioeconomic status and access to care, but not with differences in race. 展开更多
关键词 parkinsons disease medicATION sIDE Effects safety-Net HOsPITAL
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基于Apriori算法与因子分析探讨帕金森病的中医药用药规律
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作者 刘煜 李鸣 +1 位作者 杨琼 杨春娣 《中西医结合心脑血管病杂志》 2024年第3期445-451,共7页
目的:运用复杂网络分析中医药治疗帕金森病用药的相互关系。方法:收集中医药方剂治疗帕金森病的相关文献,建立中药数据库,采用SPSS软件进行复杂网络分析探讨各药物相互关系。结果:中医药治疗帕金森病高频用药排名居前6位为白芍、熟地黄... 目的:运用复杂网络分析中医药治疗帕金森病用药的相互关系。方法:收集中医药方剂治疗帕金森病的相关文献,建立中药数据库,采用SPSS软件进行复杂网络分析探讨各药物相互关系。结果:中医药治疗帕金森病高频用药排名居前6位为白芍、熟地黄、当归、甘草、钩藤、天麻,并对其进行聚类分析及因子分析,得出7类组方和11类公因子。运用关联规则分析得出中药用药以白芍-熟地黄核心药对进行加减。结论:中医药治疗帕金森病常以滋阴养血为主要原则,平肝息风、化痰散结、开窍醒神等为常用治疗方法,其核心药对为白芍-熟地黄。 展开更多
关键词 帕金森病 震颤麻痹 聚类分析 关联分析 复杂网络 用药规律
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基于“补肾调肝”法治疗帕金森病的思路
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作者 李果 梁美丹 +6 位作者 高云水 马守文 朱松柏 左龙 杨毅 卢梁 吴鹏 《中国医药科学》 2024年第5期107-110,共4页
伴随人口老龄化加剧,帕金森病(PD)的致病率呈现出被推波助澜之势,历代医家及学者对其均有独到的见解,肝肾阴虚作为其中秉要执本的病因病机,被众人所推崇。众多临床实践和基础研究证明,“补肾调肝”法作为治疗PD常规治疗法则,运用“补肾... 伴随人口老龄化加剧,帕金森病(PD)的致病率呈现出被推波助澜之势,历代医家及学者对其均有独到的见解,肝肾阴虚作为其中秉要执本的病因病机,被众人所推崇。众多临床实践和基础研究证明,“补肾调肝”法作为治疗PD常规治疗法则,运用“补肾调肝”法治疗PD常可以达到药到病除之功,被广泛应用于临床实践。通过查阅与PD相关的实验与临床研究文献,本文探讨“补肾调肝”法在治疗PD中的应用,并结合临床医案进行剖析,以期为今后的辨证论治与临床用药提供相应的思路和借鉴。 展开更多
关键词 帕金森病 “补肾调肝”法 文献研究 临床医案
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试述ICD在DRGs管理中的作用 被引量:1
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作者 吴金莉 《智慧健康》 2017年第19期14-15,共2页
随着"人人享有基本医疗服务、建立覆盖全国城乡的医疗保障体系"目标的建立,"全民医保"时代已经到来。与此同时,医保基金面临着既要保证有效供给,又要控制费用的双重压力。缓解这样的双重压力,势必要进行医疗保险付... 随着"人人享有基本医疗服务、建立覆盖全国城乡的医疗保障体系"目标的建立,"全民医保"时代已经到来。与此同时,医保基金面临着既要保证有效供给,又要控制费用的双重压力。缓解这样的双重压力,势必要进行医疗保险付费方式的改革,并且医疗费用支付方式改革必然依赖DRGs。准确无误的ICD分类是DRGs科学实施的重要保障。 展开更多
关键词 国际疾病分类 疾病诊断分组 病案管理
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基于MAC模式的医院病案处方管理系统软件的研究与开发
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作者 王珊 张文涛 《西安交通工程学院学术研究》 2024年第1期77-86,共10页
随着社会的不断发展,IT时代的迅速崛起,使得许多企业的运作方式、管理方式、技术革新、资源管理都面临非常大的挑战、创新。医院病历及处方管理系统是融合现代化医院的管理思想,确保医疗单位在病历管理中实现高效办公,规范管理。介绍了... 随着社会的不断发展,IT时代的迅速崛起,使得许多企业的运作方式、管理方式、技术革新、资源管理都面临非常大的挑战、创新。医院病历及处方管理系统是融合现代化医院的管理思想,确保医疗单位在病历管理中实现高效办公,规范管理。介绍了实现该系统所要用到的相关技术,开发工具,并运用功能结构图、流程图和E-R图等具体讲述了系统结构设计、功能模块划分和数据库的设计。本文根据软件工程开发流程,给出了病历管理系统的前后端分析和设计等文档,并根据文档给出系统的具体程序开发思考方向。 展开更多
关键词 病历管理 MVC设计模式 B/s架构 E-R图
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医院HIS系统的设计与实现 被引量:4
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作者 唐建鑫 《现代电子技术》 2013年第9期121-123,共3页
针对实现信息资源共享,加快信息传递速度,降低工作人员的劳动强度,提高医护人员工作效率,设计了一套医院信息管理系统,将医院所有日常工作改为事务处理、财务管理、物资管理、临床数据、学术资料、电子病历信息流的网络化控制结构。利... 针对实现信息资源共享,加快信息传递速度,降低工作人员的劳动强度,提高医护人员工作效率,设计了一套医院信息管理系统,将医院所有日常工作改为事务处理、财务管理、物资管理、临床数据、学术资料、电子病历信息流的网络化控制结构。利用局域网、广域网、大型分布式数据等先进的计算机技术,运用系统的理论方法,将医院各组成部分的信息处理过程综合成有机整体,提升了医院信息管理工作规范化、制度化、科学化水平,实现了医院信息技术全电子无纸化和胶片管理的目标。 展开更多
关键词 医院信息管理系统 电子病历系统 C s B s
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基于B/S架构的医院电子病历管理系统设计与研究 被引量:8
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作者 李波 《电子设计工程》 2017年第5期46-49,共4页
电子病历系统是实现数字化医院的重要内容,先要讨论电子病历管理系统的定义及作用。因B/S结构具有维护性、扩展性强等优点,因此,基于B/S结构开发电子病历管理系统满足医院发展具体要求。文中深入分析B/S架构,根据系统设计原则设计相应... 电子病历系统是实现数字化医院的重要内容,先要讨论电子病历管理系统的定义及作用。因B/S结构具有维护性、扩展性强等优点,因此,基于B/S结构开发电子病历管理系统满足医院发展具体要求。文中深入分析B/S架构,根据系统设计原则设计相应的功能模块,并配备合理的数据库,确保数据库快速实现连接。测试结果表明,设计的电子病历管理系统能快速录入、查询病案数据,能实现可靠存储病案数据等功能,对医院及时掌握某个病案具有重要辅助作用。 展开更多
关键词 B/s架构 电子病历 管理系统 功能模块
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Sleep Disorders in Parkinson's Disease: Present Status and Future Prospects 被引量:8
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作者 Yun Shen Chun-Feng Liu 《Chinese Medical Journal》 SCIE CAS CSCD 2018年第8期883-885,共3页
INTRODUCTION Parkinson's disease (PD) is the second most common neurodegenerative disorder in the world. In China, approximately 48-89% of Chinese patients with PD have been shown to be affected by sleep disorders,... INTRODUCTION Parkinson's disease (PD) is the second most common neurodegenerative disorder in the world. In China, approximately 48-89% of Chinese patients with PD have been shown to be affected by sleep disorders, in recent decades, there have been major advances in our understanding of the relationship between sleep disorders and PD, yet many questions remain unanswered. 展开更多
关键词 parkinson's disease sleep Disorders management
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Properties of oscillatory neuronal activity in the basal ganglia and thalamus in patients with Parkinson’s disease 被引量:3
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作者 G.Du P.Zhuang +3 位作者 M.Hallett Y.-Q.Zhang J.-Y.Li Y.-J.Li 《Translational Neurodegeneration》 SCIE CAS 2018年第1期154-166,共13页
Background:The cardinal features of Parkinson’s disease(PD)are bradykinesia,rigidity and rest tremor.Abnormal activity in the basal ganglia is predicted to underlie the mechanism of motor symptoms.This study aims to ... Background:The cardinal features of Parkinson’s disease(PD)are bradykinesia,rigidity and rest tremor.Abnormal activity in the basal ganglia is predicted to underlie the mechanism of motor symptoms.This study aims to characterize properties of oscillatory activity in the basal ganglia and motor thalamus in patients with PD.Methods:Twenty-nine patients with PD who underwent bilateral or unilateral electrode implantation for subthalamic nucleus(STN)DBS(n=11),unilateral pallidotomy(n=9)and unilateral thalamotomy(n=9)were studied.Microelectrode recordings in the STN,globus pallidus internus(GPi)and ventral oral posterior/ventral intermediate of thalamus(Vop/Vim)were performed.Electromyography of the contralateral limbs was recorded.Single unit characteristics including interspike intervals were analyzed.Spectral and coherence analyses were assessed.Mean spontaneous firing rate(MSFR)of neurons was calculated.Analysis of variance and χ^(2) test were performed.Results:Of 76 STN neurons,39.5% were 4–6 Hz band oscillatory neurons and 28.9% were β frequency band(βFB)oscillatory neurons.The MSFR was 44.2±7.6 Hz.Of 62 GPi neurons,37.1% were 4–6 Hz band oscillatory neurons and 27.4% were βFB neurons.The MSFR was 80.9±9.6 Hz.Of 44 Vop neurons,65.9% were 4–6 Hz band oscillatory neurons and 9%were βFB neurons.The MSFR was 24.4±4.2 Hz.Of 30 Vim oscillatory neurons,70% were 4–6 Hz band oscillatory neurons and 13.3% were β FB neurons.The MSFR was 30.3±3.6 Hz.Further analysis indicated that proportion of βFB oscillatory neurons in STN and GPi was higher than that of similar neurons in the Vop and Vim(P<0.05).Conversely,the proportion of 4–6 Hz band oscillatory neurons and tremor related neurons in the Vim and Vop was higher than that of STN and GPi(P<0.05).The highest MSFR was for GPi oscillatory neurons whereas the lowest MSFR was for Vop oscillatory neurons(P<0.005).Conclusion:The alterations in neuronal activity in basal ganglia play a critical role in generation of parkinsonism.β oscillatory activity is more prominent in basal ganglia than in thalamus suggesting that the activity likely results from dopaminergic depletion.While both basal ganglia and thalamus have tremor activity,the thalamus appears to play a more important role in tremor production,and basal ganglia β oscillatory activity might be the trigger. 展开更多
关键词 parkinsons disease Basal ganglia The subthalamic nucleus The globus pallidus internus The ventrolateral thalamus Oscillatory activity Microelectrode recordings
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Tyrosine hydroxylase-positive cells and dopaminergic neuronal function in human embryonic stem cells: An electrophysiological validation 被引量:1
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作者 Tianran Song Yue Wang +1 位作者 Guian Chen Guogang Xing 《Neural Regeneration Research》 SCIE CAS CSCD 2010年第3期185-190,共6页
BACKGROUND: Induced differentiation strategies and cytochemical properties of human embryonic stem ceils (hESCs) have been investigated. However, the electrophysiological functions of tyrosine hydroxylase (TH)-po... BACKGROUND: Induced differentiation strategies and cytochemical properties of human embryonic stem ceils (hESCs) have been investigated. However, the electrophysiological functions of tyrosine hydroxylase (TH)-positive cells dedved from hESCs remain unclear. OBJECTIVE: To investigate the differentiation efficiency of TH-positive cells from hESCs in vitro using modified four-step culture methods, including embryoid body formation, and to examine the functional characteristics of the differentiated TH-positive cells using electrophysiological techniques. DESIGN, TIME AND SETTING: Neuroelectrophysiology was performed at the Reproductive Medicine Center and Stem Cell Research Center, Peking University Third Hospital, and the Neuroscience Research Institute and Department of Neurobiology, Peking University, from September 2004 to August 2008. MATERIALS: The hESC line, PKU-1.1, a monoclonal cell line derived from a pre-implantation human blastocyst in the Reproductive Medical Center of Peking University Third Hospital. The patch clamp recording system was provided by the Neuroscience Research Institute and Department of Neurobiology, Peking University. METHODS: The hESC line was induced to differentiate into TH-positive cells in vitro using a modified four-step culture method, including the formation of embryoid body, as well as the presence of sonic hedgehog and fibroblast growth factor 8. The cell karyotype was assessed by G-banding karyotype analysis techniques and specific markers were detected immunocytochemically. Whole-cell configuration was obtained after obtaining a tight seal of over 1 GΩ. Ionic currents were detected by holding the cells at -70 mV and stepping to test voltages between -80 and 40 mV in 10-mV increments in voltage-clamp configuration. MAIN OUTCOME MEASURES: We measured the cell karyotype, specific cell markers, and the electrophysiological properties of the voltage-gated ion channels on the cell membrane of TH-positive dopaminergic cells differentiated from our hESCs line in vitro. RESULTS: The differentiated cells had a consistent appearance, and the majority of cells (〉 90%) expressed TH and β-tubulion, as well as the neural progenitor marker, nestino Cell karyotype analysis demonstrated that all of the hESCs had a stable and normal karyotype (46, XX) after differentiation. In addition, patch clamp recording showed that the 10 recorded TH-positive cells exhibited a fast inward current when the test voltage depolarized to -30 mV, and a delayed outward current when the test voltage depolarized to -10 mV. The peak of inward current was obtained at voltage between 10 mV and 0 mV, while the peak of outward current was obtained at 40 mV. The average peak of inward current density was ( -50.05 ± 15.50) pA/pF, and the average peak of outward current density was (41.98 ± 13.55) pA/pE CONCLUSION: More than 90% of the differentiated hESC-derived cells induced by the modified four-step culture method exhibit dopaminergic neuronal properties, including general electrophysiological functional properties, such as functional potassium and sodium channels. 展开更多
关键词 human embryonic stem cell induced differentiation dopaminergic neurons patch clamp recording parkinson's disease
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利用DRGs原理提升老年医学科疾病管理水平
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作者 徐岚 张殿福 朱峰 《实用老年医学》 CAS 2021年第5期537-540,共4页
目的通过分析老年医学科诊断相关组(DRGs)分组费用异常数据,发现病案首页填写问题,并针对问题进行培训,以提升老年医学科疾病管理的水平。方法提取东南大学附属中大医院溧水分院老年医学科2019年1~6月出院病历中基于DRGs分组为异常的病... 目的通过分析老年医学科诊断相关组(DRGs)分组费用异常数据,发现病案首页填写问题,并针对问题进行培训,以提升老年医学科疾病管理的水平。方法提取东南大学附属中大医院溧水分院老年医学科2019年1~6月出院病历中基于DRGs分组为异常的病案,将其分为极高费用病案、极低费用病案以及未入组病案,分析病案发生异常的原因,并结合DRGs分组原理对医生进行针对性培训。收集培训后2020年1~6月出院病案,分析病案首页填写水平的变化,并以此反映其疾病管理水平的提升情况。结果共获取2019年1~6月890份出院病案,其中极高费用病案50份(占5.62%)、极低费用病案21份(占2.36%)、未入组病案33份(占3.71%),病案首页诊断与手术操作填写合格率为83.22%。异常病案的主要原因为诊断选择错误、诊断遗漏、诊治名称不规范、治疗选择错误等。经过培训后,分析2020年1~6月老年医学科685份出院病案,其中极高费用病案7份(占1.02%)、极低费用病案9份(占1.31%)、未入组病案4份(占0.58%),病案首页诊断与手术操作填写合格率为96.35%。与2019年同期相比,2020年老年医学科出院极高费用病案、极低费用病案及未入组病案发生率明显下降(P均<0.05);首页填写合格率明显提升(P<0.05)。结论通过基于DRGs分组费用异常病案的分析,有针对性地对老年医学科医生进行培训,可显著提升老年医学科医生病案首页填写水平,同时提升了疾病管理水平。 展开更多
关键词 疾病诊断相关组 老年医学科 病案首页 疾病管理
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多学科协作管理模式提高病案首页主要诊断正确率的研究 被引量:1
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作者 刘玲 陶源 +2 位作者 高旸昉 曹冬梅 倪慧萍 《中国卫生标准管理》 2023年第14期6-10,共5页
目的应用多学科协作管理模式对住院病案首页主要诊断进行管理,评价其应用效果。方法采取随机等距离抽样,抽取2020年1—6月2999份住院病案首页作为对照组,2021年1—6月2815份住院病案首页作为干预组。对比分析多学科协作管理模式实施前... 目的应用多学科协作管理模式对住院病案首页主要诊断进行管理,评价其应用效果。方法采取随机等距离抽样,抽取2020年1—6月2999份住院病案首页作为对照组,2021年1—6月2815份住院病案首页作为干预组。对比分析多学科协作管理模式实施前后病案首页主要诊断选择正确率、主要诊断编码正确率、主要诊断错误责任情况、主要诊断编码错误原因。结果某院实施多学科协作管理模式后,干预组的病案首页主要诊断选择正确率为89.17%,明显高于对照组的71.82%,差异有统计学意义(P<0.05)。干预组的主要诊断编码正确率为92.93%,明显高于对照组的73.26%,差异有统计学意义(P<0.05)。干预组的主要诊断选择正确率、主要诊断编码正确率较对照组均得到提高。实施多学科协作管理模式后,干预组的住院病案首页主要诊断错误责任类型均低于对照组,差异有统计学意义(P<0.05)。主要诊断编码为残余类目、肿瘤病历主诊选择错误、使用无效主诊断编码、以临终状态作为主诊在多学科协作管理模式实施后错误数量明显变少,差异有统计学意义(P<0.05)。结论多学科协作管理模式对提高病案首页主要诊断编码正确率有一定效果,值得推广。 展开更多
关键词 多学科协作 主要诊断 质量控制 病案首页 疾病编码 管理模式
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疾病诊断相关分组支付背景下病案精细化质量管理对提升病案质量的影响 被引量:2
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作者 肖一千 郭伟 +2 位作者 彭萌 魏艳淋 张连军 《医疗装备》 2023年第11期35-37,共3页
目的探讨疾病诊断相关分组(DRG)支付背景下的病案精细化质量管理对提升病案管理质量的影响。方法将2021年1—12月医院DRG支付背景下1000份病例资料设为对照组;将2022年1—10月医院DRG支付背景下1000份病例资料设为观察组。对照组采用常... 目的探讨疾病诊断相关分组(DRG)支付背景下的病案精细化质量管理对提升病案管理质量的影响。方法将2021年1—12月医院DRG支付背景下1000份病例资料设为对照组;将2022年1—10月医院DRG支付背景下1000份病例资料设为观察组。对照组采用常规病案管理,观察组采用精细化质量管理。对比两组病案管理质量、医疗纠纷发生率、医务人员满意度、管理人员职能考核合格率。结果观察组病案首页质量合格率、医务人员满意度、管理人员职能考核合格率高于对照组,缺页缺项率、医疗纠纷发生率低于对照组,差异有统计学意义(P<0.05)。结论DRG支付背景下的病案精细化质量管理能提升病案管理质量、提升医务人员满意度及管理人员职能,减少医疗纠纷。 展开更多
关键词 病案管理 疾病诊断相关分组 精细化质量管理 病案质量
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论培训工作对绩效考核指标与疾病诊断相关分组数据的影响 被引量:1
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作者 侯敏 殷俊华 +1 位作者 王惠红 肖树 《中国医学工程》 2023年第4期47-51,共5页
目的 质控约束从单纯的规章制度、检查评分转变为一种自觉地行动准则。方法 全院组织培训后,所有医师(含住培、进修、实习医师)参与考试,考试按照首页四大类信息设置分填空题5道,单选题10道,多选题5道利用手机扫码考试,每场考试题库设... 目的 质控约束从单纯的规章制度、检查评分转变为一种自觉地行动准则。方法 全院组织培训后,所有医师(含住培、进修、实习医师)参与考试,考试按照首页四大类信息设置分填空题5道,单选题10道,多选题5道利用手机扫码考试,每场考试题库设置自动更新,考试成绩用Excel进行统计。结果 病案首页质量控制体系建立前后病案首页数据质量从88.35%提高到98.36%,疾病诊断相关分组(DRG)入组病案数提高了23.57%。结论 在三级公立医院绩效考核中的数据指标,是真正体现一个医院三级诊疗水平的核心数据,通过培训前后对比,增强了医生对首页填写重要性的认识,能够使数据质量大幅度上升。 展开更多
关键词 病案首页 管理 疾病诊断相关分组 绩效考核
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不同针法治疗帕金森病的特点和作用机制
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作者 谭伟强 范靖琪 +2 位作者 卢玮婧 陈缘缘 庄礼兴 《世界中医药》 CAS 2023年第24期3621-3626,共6页
国内外大量研究证明,针灸可通过不同的作用机制改善帕金森病(Parkinson′s Disease,PD)的症状,具有显著的有效性和安全性。学者们根据PD发病的不同病因病机特点和现代医学对大脑的认识,与针灸理论相结合,总结出多种针灸治则和选穴处方,... 国内外大量研究证明,针灸可通过不同的作用机制改善帕金森病(Parkinson′s Disease,PD)的症状,具有显著的有效性和安全性。学者们根据PD发病的不同病因病机特点和现代医学对大脑的认识,与针灸理论相结合,总结出多种针灸治则和选穴处方,如颤三针疗法、岐黄针疗法、三焦针法等。 展开更多
关键词 帕金森病 针法 配穴 作用机制 病因病机 中医基础理论 现代医学理论 研究进展
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