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目的分析神经科总住院医师会诊病例的构成特点,从一个方面反映总住院医师的工作情况。方法统计北京协和医院神经科1名总住院医师在2003年8月1日至2004年1月31日会诊的病例。结果共新会诊患者607例,女性305例,男性302例,年龄5个月至92岁,平均年龄55·2岁,平均每周新会诊24例。急症会诊208例(34·3%),常规会诊399例(65·7%)。362例(59·6%)继发于系统性疾病;66例(10·9%)与医源性因素有关。急症会诊以代谢性脑病最多(92例),占急症会诊的44·2%,病因包括呼吸衰竭、肾功能衰竭、多器官功能衰竭等;其次为急性脑血管病51例;第三为癫发作23例。内科常规会诊病例以周围神经病最多(69例),占内科常规会诊的17·3%(69/398),病因包括糖尿病、血管炎/结缔组织病、肿瘤相关的周围神经病等。外科和妇科约请神经科常规会诊主要目的是围手术期的神经科疾病评估和预防。结论会诊工作具有特殊性和挑战性,神经科总住院医师应该了解会诊病例特点,在会诊中学习和积累经验。
Objective To analyze the characteristics of the consultation of neurological general resident physicians and to reflect the work of the resident residents in one aspect. Methods Statistics Beijing Union Medical College Hospital Department of Neurology 1 Resident in August 1, 2003 to January 31, 2004 consultation. Results A total of 607 new patients were enrolled in the study, 305 were female and 302 were male, ranging in age from 5 months to 92 years, with an average age of 55.2 years and an average of 24 weekly new consultations. There were 208 emergency cases (34.3%) and 399 routine consultations (65.7%). 362 cases (59.6%) were secondary to systemic diseases; 66 cases (10.9%) were related to iatrogenic factors. The number of acute encephalopathy (92 cases) was the highest in emergency consultation, accounting for 44.2% of the emergency consultation. The causes include respiratory failure, renal failure, multiple organ failure, etc .; secondly, 51 cases of acute cerebrovascular disease; and thirdly epileptic Attack in 23 cases. There were 69 cases with peripheral neuropathy in conventional medical consultation, accounting for 17.3% (69/398) of routine medical consultation, the cause of which included diabetes, vasculitis / connective tissue disease and tumor-related peripheral neuropathy. Surgery and gynecology appointment routine consultation of neurology is the main purpose of perioperative neurological disease assessment and prevention. Conclusion The consultation work is special and challenging. The neurological general resident should understand the characteristics of the consultation cases and learn and accumulate experience during the consultation.