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Eur Heart J - Qual Care Clin Outcomes:我国十年间冠脉搭桥手术质量进步

2017-10-25 文韬 中国循环杂志

阜外医院胡盛寿院士等研究揭示,在过去十年间,我国城市教学医院的冠脉搭桥手术相关院内死亡率和严重并发症发生率明显下降。

阜外医院胡盛寿院士等研究揭示,在过去十年间,我国城市教学医院的冠脉搭桥手术相关院内死亡率和严重并发症发生率明显下降。

院内死亡率从2.8%降至1.6%,7天院内死亡率从1.5%降至0.8%。与2004年相比,2013年冠脉搭桥手术患者的院内死亡风险下降近40%。严重并发症发生率从7.8%降至3.8%。死亡率和严重并发症发生率下降在不同年龄组中均保持一致。

2004-2013年,虽然患者的中位术前住院时间未发生改变,仍是9天。但术后住院时间从12天缩短至10天,总住院时间从22天缩短至20天。其中总住院时间超过30天的患者比例从24.8%降至17.4%。

不过,研究者指出,我国CABG某些方面还需改善。

首先,医院水平差异显着,尤其是严重并发症发生率高于死亡率,提示并发症发生率仍有很大的改善空间。其次,尽管住院时间缩短,但术前和术后住院时间仍远远长于西方国家。

此外,与增设更多的心脏手术中心相比,我国应增加对欠发达地区的投资以减少区域资源配置不平等,培养社区医院和康复中心的能力,以及改变薪酬方案以激励更高质量的护理。

该研究纳入2004-2013年我国102家城市教学医院中,接受单纯CABG的40 652例患者。

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    2017-10-27 zhaojie88
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    2017-10-27 yese
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    2017-10-27 slcumt
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    2017-10-27 longqijun254
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    2017-10-25 131****1460

    学习了受益匪浅

    0

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    2017-10-25 清风拂面

    很好的文章.谢谢分享

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