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目的比较北京和巴黎社区获得性肺炎的急诊治疗情况。方法收集2003年10月1日至2004年9月30日北京大学人民医院急诊科和巴黎市中心H(?)tel-Dieu 医院急诊科的社区获得性肺炎患者病情和治疗方面的信息,通过Fine危险分层评估两组患者,并对治疗进行比较。结果(1)两组患者在五个 Fine分级中的分布差异没有统计学意义(P＞0．05),因此两组患者病情有可比性。(2)北京组患者和巴黎组相比,三代头孢类、碳青霉烯类等高级抗生素的用药比例高(P＜0．01),而青霉素和大环内酯类用药等基础药物的比例低(P＜0．01)；静脉用药比例高,而口服药比例低(P＜0．01)。北京组病人抗生素治疗和指南的一致性(59．6%)显著低于巴黎组患者(88．6%,P＜0．01)。(3)北京组患者全部在4 h 内得到抗生素治疗,而巴黎组患者92例(52．2%)在4 h 内得到抗生素治疗。(4)急诊观察室停留时间北京组患者显著长于巴黎组患者。结论北京和巴黎社区获得性肺炎的急诊处理有很大的不同,我们应借鉴巴黎,以完善自己。
Objective To compare the emergency treatment of community-acquired pneumonia in Beijing and Paris. Methods The information on the condition and treatment of community-acquired pneumonia in the emergency department of People’s Hospital of Peking University from September 1, 2003 to September 30, 2004 and the emergency department of H (?) Tel-Dieu Hospital, Central Paris was collected and analyzed by Fine Risk stratification was assessed in both groups and the treatment was compared. Results (1) There was no significant difference between the two groups in the distribution of the five Fine grades (P> 0.05), so the two groups of patients were comparable. (2) Compared with Paris group, the proportion of high-level antibiotics such as third-generation cephalosporins and carbapenems in Beijing group was higher than that in Paris group (P <0.01), while the proportion of basic drugs such as penicillin and macrolide (P <0.01). The proportion of intravenous drugs was high, while the proportion of oral drugs was low (P <0.01). The consistency of antibiotic treatment and guidelines among Beijing patients (59.6%) was significantly lower than that of Paris patients (88.6%, P <0.01). (3) All patients in the Beijing group received antibiotics within 4 h, whereas 92 patients (52.2%) in the Paris group received antibiotics within 4 h. (4) Emergency observation room stay in Beijing group was significantly longer than patients in Paris group. Conclusions The emergency treatment of community-acquired pneumonia in Beijing and Paris is very different. We should learn from Paris to improve ourselves.