小儿腹泻规范诊疗临床应用价值
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摘要
目的探讨规范化诊疗措施在小儿腹泻中应用对患儿疗效及家属满意度影响。方法本院于2017年5月在儿科实施"小儿腹泻规范诊疗",于实施前6月、实施后6月内分别选取腹泻患儿80例作为对照组和实验组,对照组按照传统诊治方法治疗,实验组严格按照规范化诊疗治疗,比较2组患儿症状改善时间、住院时间、住院费用、疗效及家属满意度。结果实验组患儿腹泻、呕吐、脱水、发热症状恢复正常时间分别为(2.2±0.5)d、(1.6±0.6)d、(2.0±0.5)d、(1.5±0.6)d,显著短于对照组的(2.6±0.6)d、(2.1±0.5)d、(2.4±0.7)d、(1.7±0.4)d,差异有统计学意义(t值分别=4.5808、5.7260、4.1590、2.4807,P值均<0.05)。实验组患儿住院时间(3.5±0.7)d、住院费用(1 422.7±206.7)元,均少于对照组的(4.4±1.1)d、(1 684.4±213.4)元,差异有统计学意义(t值分别=6.1739、7.8787,P值均<0.01)。实验组患儿疗效为98.75%,显著高于对照组的88.75%(X~2=5.2267,P=0.0222)。实验组患儿家属满意度为97.50%,显著高于对照组的85.00%(X~2=6.3405,P=0.0118)。结论规范化诊疗措施在小儿腹泻中应用能协助提高患儿疗效,缩短患儿住院时间和住院费用,提高家属治疗满意度。
Objective To explore the curative effect of the application of the standardized diagnosis and treatmentmeasures for children's diarrhea and the application on family members' satisfaction.MethodsIn May 2017, the"Pediat-ric Diarrhea Standard Diagnosis and Treatment"was implemented in pediatrics. Before the implementation, within 6 months,80 patients with diarrhea were selected as a control group, and after the implementation, other 80 patients with diarrhea wereselected as an experimental group within 6 months. The control group was treated by the traditional methods, and the experi-mental group was treated strictly according to the standard. The symptoms of the two groups were compared. The time of im-provement, hospital stay, hospitalization costs, efficacy, and family members' satisfaction were investigated and the resultswere analyzed and compared between two groups.ResultsIn the experimental group, the recovery time of diarrhea, vomit-ing, dehydration and fever was significantly shorter than that of the control group [(2.2±0.5) d vs.(2.6±0.6) d,(1.6±0.6) d vs.(2.1±0.5) d,(2.0±0.5) d vs.(2.4±0.7) d,(1.5±0.6) d vs.(1.7±0.4) d], respectively, and there were significant differences(t=4.5808, 5.7260, 4.1590, 2.4807, P=0.0000, 0.0000, 0.0001, 0.0142, respectively).The hospitalization time and hospitaliza-tion costs of the infants in the experimental group were both less than those in the control group [(3.5±0.7) d vs.(4.4±1.1) d,and(1422.7±206.7) yuan vs.(1684.4±213.4) yuan, t=6.1739, 7.8787, P=0.0000, 0.0000 respectively].The efficacy of the ex-perimental group was significantly higher than that of the control group(98.75% vs. 88.75%, X~2=5.2267, P=0.0222).The sat-isfaction rate of the family members in the experimental group was significantly higher than that of the family members in thecontrol group(97.50% vs. 85.00%,X~2=6.3405, P=0.0118].ConclusionThe application value of standardized diagnosisand treatment of pediatric diarrhea in children with diarrhea can improve the efficacy, shorten the hospitalization time, andreduce hospitalization costs, and also improve the satisfaction of family members.
Objective To explore the curative effect of the application of the standardized diagnosis and treatmentmeasures for children's diarrhea and the application on family members' satisfaction.MethodsIn May 2017, the"Pediat-ric Diarrhea Standard Diagnosis and Treatment"was implemented in pediatrics. Before the implementation, within 6 months,80 patients with diarrhea were selected as a control group, and after the implementation, other 80 patients with diarrhea wereselected as an experimental group within 6 months. The control group was treated by the traditional methods, and the experi-mental group was treated strictly according to the standard. The symptoms of the two groups were compared. The time of im-provement, hospital stay, hospitalization costs, efficacy, and family members' satisfaction were investigated and the resultswere analyzed and compared between two groups.ResultsIn the experimental group, the recovery time of diarrhea, vomit-ing, dehydration and fever was significantly shorter than that of the control group [(2.2±0.5) d vs.(2.6±0.6) d,(1.6±0.6) d vs.(2.1±0.5) d,(2.0±0.5) d vs.(2.4±0.7) d,(1.5±0.6) d vs.(1.7±0.4) d], respectively, and there were significant differences(t=4.5808, 5.7260, 4.1590, 2.4807, P=0.0000, 0.0000, 0.0001, 0.0142, respectively).The hospitalization time and hospitaliza-tion costs of the infants in the experimental group were both less than those in the control group [(3.5±0.7) d vs.(4.4±1.1) d,and(1422.7±206.7) yuan vs.(1684.4±213.4) yuan, t=6.1739, 7.8787, P=0.0000, 0.0000 respectively].The efficacy of the ex-perimental group was significantly higher than that of the control group(98.75% vs. 88.75%, X~2=5.2267, P=0.0222).The sat-isfaction rate of the family members in the experimental group was significantly higher than that of the family members in thecontrol group(97.50% vs. 85.00%,X~2=6.3405, P=0.0118].ConclusionThe application value of standardized diagnosisand treatment of pediatric diarrhea in children with diarrhea can improve the efficacy, shorten the hospitalization time, andreduce hospitalization costs, and also improve the satisfaction of family members.
引文
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[14]刘晓峰,张扬,张兰荣,等.北京市肠道门诊腹泻患者病原谱分析[J].中华传染病杂志,2015,33(8):460-464.
[15]Yodmeeklin A,Khamrin P,Chuchaona,et al.Saffold Viruses in pediatric patients with diarrhea in Thailand[J].J Med Virol,2015,87(4):702-707.
[16]Lu QB,Huang DD,Zhao J,et al.An increasing prevalence of recombinant GIl norovirus in pediatric patients with diarrhea during2010-2013 in China[J].Infect Genet Evol,2015,31:48-52.
[17]Ye X,Van JN,Munoz FM,et al.Noroviruses as a cause of diarrhea in immunocompromised pediatric hematopoietic stem gell and solid organ transplant recipients[J].Am J Tansplant,2015,15(7):1874-1881.
[18]Pode SB,Reish O,Aktuglu ZC,et al.Bitterness of glucose/galactose:Novel mutations in the SLC5A1 gene[J].J Pediatr Gastroenterol Nutr,2014,58(1):57-60.
[2]Nicholson MR,Osgood CL,Acra SA.et al.Clostridium difficile infection in the pediatric transplant patient[J].Pediatri transplant,2015,19(7):792-798.
[3]叶礼燕,陈凤钦.腹泻病诊断治疗指南[J].实用儿科临床杂志,2009,24(19):1538-1540.
[4]中华医学会儿科学分会消化学组.儿童腹泻病诊断治疗原则的专家共识[J].中华儿科杂志,2009,47(8):634-636.
[5]Singhi AD,Goyal A,Davison JM,et al.Pediatric autoimmune enteropathy:an entity frequently associated with immunodeficiency disorders[J].Mod pathol,2014,27(4):543-553.
[6]张金仿,王刚,苏建荣,等.北京友谊医院2015-2017年门诊腹泻病例A群轮状病毒特征分析[J].中华实验和临床病毒学杂志,2017,31(6):530-533.
[7]陆晓凤,吴建祥,徐少毅,等.重症加强治疗病房腹泻患者艰难梭菌检测的敏感方法[J].中华危重病急救医学,2015,27(6):525-526.
[8]Mans J,Murray TY,Kiulia NM,et al.Human caliciviruses detected inHIV-seropositive children in Kenya[J].J Med Virol,2014,86(1):75-81.
[9]杨涛,杨刚.杭州市余杭区小儿轮状病毒腹泻临床检测和流行病学特征分析[J].实用预防医学,2014,21(5):557-560.
[10]Thongprachum A,Takanashi S,Kalesaran AF,et al.Four-year study of viruses that cause diarrhea in Japanese pediatric outpatients[J].J Med Virol,2015,87(7):1141-1148.
[11]Devona W.Treatment of rotavirus-associateddiarrhea using enteral immunoglobulins for pediatric stem cell transplant patients[J].JOnco Pharm Pract,2015,21(3):238-240.
[12]余万辉,徐言俊,吴时光,等.心肌酶谱检测在小儿轮状病毒腹泻诊治中的应用价值[J].中国临床医生杂志,2017,45(8):112-114.
[13]刘白薇,高志勇,王全意,等.北京市2013-2014年肠道门诊腹泻患者中诺如病毒感染的流行病学及临床特征分析[J].中华流行病学杂志,2015,36(4):383-386.
[14]刘晓峰,张扬,张兰荣,等.北京市肠道门诊腹泻患者病原谱分析[J].中华传染病杂志,2015,33(8):460-464.
[15]Yodmeeklin A,Khamrin P,Chuchaona,et al.Saffold Viruses in pediatric patients with diarrhea in Thailand[J].J Med Virol,2015,87(4):702-707.
[16]Lu QB,Huang DD,Zhao J,et al.An increasing prevalence of recombinant GIl norovirus in pediatric patients with diarrhea during2010-2013 in China[J].Infect Genet Evol,2015,31:48-52.
[17]Ye X,Van JN,Munoz FM,et al.Noroviruses as a cause of diarrhea in immunocompromised pediatric hematopoietic stem gell and solid organ transplant recipients[J].Am J Tansplant,2015,15(7):1874-1881.
[18]Pode SB,Reish O,Aktuglu ZC,et al.Bitterness of glucose/galactose:Novel mutations in the SLC5A1 gene[J].J Pediatr Gastroenterol Nutr,2014,58(1):57-60.